Online Donation

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ANNUAL FUND GIFT FORM

Thank you for making a pledge to the Moravian Academy Annual Fund. Please provide the information requested below and click the "Submit" button. Your pledge will be recorded and an acknowledgement will be mailed to you.

All pledge payments are to be paid by June 30, 2009, in order to count in the Annual Fund for 2008-2009.

Personal Information:

[fields with an asterisk* are required]

* First Name:
* Last Name:
Maiden Name, if applicable:
Class Year:
* E-mail Address:	(This is required to confirm receipt of form.)
* Phone:
Postal Address:

City:
State:
Zip:

About my Gift:

Yes, I / we would like to help Moravian Academy meet its greatest needs by donating a gift of $	($xx.xx) (excluding match below).
	My spouse is also a Moravian Academy graduate. Please credit this gift jointly.
Spouse's maiden name, if applicable:
Spouse's Class Year:
	I would like to transfer stock to pay my pledge.
My / our gift will be matched by:	(Company name) (Please obtain and forward a matching gift form.)

I would like my gift to support:	MA's Greatest Needs Financial Aid Faculty Athletics Libraries Fine and Performing Arts
This gift is:
Dedicated to/in honor of:
In memory of:

Send recognition card to:
Name
Address
City
State
Zip

Installment Plan Options:

You can choose to pay your gift in installments. The amount you have chosen to donate will be divided according to the frequency you select and will be automatically charged to your credit/debit card or withdrawn from your bank account at the selected intervals over the year.
	I would like to pay my gift on an installment plan
Please charge my credit card (enter card information below)

Please automatically withdraw from my bank account (enter account information below)

Method of Payment:


	Credit Card
* Credit Card Type:
* Name on Credit Card:
* Credit Card Number:
* Expiration Date:	month year
* Security Code:	(What's this?)

	Check
	If you are paying by check, please write WEBSITE on the memo line for reference. Please make your check payable to: MORAVIAN ACADEMY 7 E. Market St. Bethlehem PA 18018

	Withdraw from my bank account
* Bank Account No.
* Bank Routing No.
* Account Type	Checking
	Savings

	Bill me

Development

	Annual Fund
	Moravian Academy Ball
	Giving Opportunities
	Merle-Smith Society
	The Naomi Haupert de Neufille Society
	Online Donation
	Ways of Giving

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