Band Program Endowment: Statement of Intent

Please use the form below to make a multi-year pledge to the band program endowment in honor of the program's sesquicentennial anniversary.

If you would rather make a one-time gift, please use our online giving form.

After completing the statement of intent, a member of the Office of College Advancement will be in touch.

Please contact Evan Sammons '20 with questions at evansammons@augustana.edu or 309-794-7575.

Multi-year Pledge Information

DONOR INFORMATION
Please include only one person's information per couple; spouse/domestic partner giving is automatically linked.

NOTE: If you accessed this form via an email and your information is already pre-filled, changing any of it will update your Augustana record. If you have a joint email address with a spouse and their information is displayed, please do not change it to your information, as this will overwrite your spouse's record with your information.

Full First Name

Preferred First Name (if different from your full first name)

Legal Last Name (please do not include any former last names)

Email Address

Birthdate (for matching to your Augustana record)

Mailing Address

Country

Street

City

Region

Postal Code

In support of Augustana College, I/we intend to make a personal commitment of the following amount to the band program endowment during the next five years.

My/our commitment is a cash gift payable over the following number of years:

__________________________________________________________________________

Year one

Month

Amount

__________________________________________________________________________

Year two

Month

Amount

__________________________________________________________________________

Year three

Month

Amount

__________________________________________________________________________

Year four

Month

Amount

__________________________________________________________________________

Year five

Month

Amount

__________________________________________________________________________

Would you like us to remind you when a pledge payment is due?

Which month would you like your pledge reminder to be sent?

If you are making your gift through a Donor Advised Fund or IRA, please notify us when the gift is on its way. Please ask your financial institution to include your name and area of support on the paperwork we receive.

Estate gifts also may be given in support of the band program endowment. Would you like to make an estate commitment at this time?

What is the amount you intend to commit to the endowment referenced on this form?

How do you plan to give this gift from your estate?

Please describe the arrangement:

What is the name of your executor, trustee or plan administrator?

Gift Recognition

Do you authorize Augustana College to recognize your gift by publishing your name(s) and commitment level in donor rosters, honor rolls and other related college print and online publications?

This commitment is not a legally binding pledge or obligation and I/we (donor(s)) reserve the right to amend this Statement of Intent at a later date.

Please type your name(s) as your signature(s)