Regional Convention Center Building Pledge

My COMMITMENT
● Regional Convention Center Building Fund Commitment for 2017:

Please select a commitment group
● The Bronze Commitment Group$100+

$100 - $499 Commitment
Amount: $
Per:

WeekMonthYearOne Time Only
Start Date

MonthDayYear
● The Silver Commitment Group $500+

$500 - $999 Commitment
Amount: $
Per:

WeekMonthYearOne Time Only
Start Date

MonthDayYear
● The Gold Commitment Group:$1000+

$1000 + Commitment
Amount: $
Per:

WeekMonthYearOne Time Only
Start Date

MonthDayYear
PERSONAL INFORMATION

Tell us about yourself
Name:*

First NameLast Name
E-mail:*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide your email address if you would like a digital copy to be emailed to you for your records.
E-mail
Finalize your payments
Enter the right amount based on the level or group you have selected.*

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