CCAM Pledge Form

Required fields are indicated in red 

I/We pledge a tax-deductible gift to support the Center for Creative and Applied Media Campaign, knowing that media literacy is vital for students and faculty at Evergreen. (All pledges must be completed by December 31, 2011.)

Donor recognition will be provided at the entryway to the CCAM complex. The following gift levels will be acknowledged:
$20,000 and above:  Mogul
15,000 and above:  Patron
10,000 and above:  Backer
5,000 and above:  Friend
1,000 and above:  Fan

Pledge Amount $

The intention is to make payments as follows:

Date Amount $

Date Amount $

Date Amount $

Please mark any that apply:

I/we work for an organization that matches employee’s gifts.

I/we would like details on the tax advantages of giving appreciated assets.

I/we know of an individual/company/foundation that might support CCAM.

Name of individual/company/foundation:

Please provide information on area naming possibilities for gifts of $25,000 or more.

Name Mailing Address

Email Phone

Gifts to The Evergreen State College Foundation are tax-deductible to the extent allowed by law.