2025-2026 Pledge Form UUCLV

Please fill out this form and click submit.

Date

Yes, I/We want to support my/our faith community of UUCLV with a financial commitment for the 2025-2026 year, beginning in July 2025.

I am a

Please select one option.

Member of the congregation Friend of the Congregation Other (Please use Comments section to describe)

Full Name

Spouse/Partner's Name

Street Address and Zip Code

Phone (Please indicate if this is a cell phone (c) or home phone (h))

Additional Phone (Please indicate if this is a cell phone (c) or home phone (h)) or your spouse's/partners

Email Address

This address will receive a confirmation email

I / We are pledging for the UUCLV 2025 - 2026 Fiscal Year.

The full amount for the 2025- 2026 year I/We am/are Pledging is:

The amount I/We am/are pledging will be fulfilled by:

Please select one option.

Monthly payments Weekly payments Every other week payments Quarterly payments 2 times a year payments an Annual payment Other

This works out to payments of

I/We will fulfill my/our pledge through

Please select one option.

Bill Pay set up by me/us through my/our bank Automatic Payment scheduled in Breeze by me/us Automatic Payment scheduled with UUCLV's Admin help (I/we will make an appointment.) Check Cash Other: Include Credit Card charges via Breeze, in office, or otherwise

COMMENTS

Optional: Updated Information

Birthdate

Partner/Spouse's Birthdate

Children Under 18 Names and Birthdates

Emergency Contact Name

Emergency Contact information (phone/email/address)

Relationship to emergency contact

Any allergies or health conditions we need to be aware of

Description

Please fill out this form and click submit.

2025-2026 Pledge Form UUCLV

Description

Please Fix the Following