Donation Pledge Form

Please fill out the form below to make a pledge to the Academy In Manayunk. Your gift can be designated for the Annual Giving fund or one of the restricted funds. You can also make a gift in honor or in memory of someone. After submitting the form, you will see instructions for fulfilling your pledge by credit card or check. For additional information, please call the Academy In Manayunk at (215) 483-2461.

Your name: required field

This donation is a joint gift with:

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Please contact me by (check all that apply):
postal mail    email    home phone    daytime phone   
please don't contact me at this time

I/we would like to make a donation to: required field

I wish to make a gift at the following level: required field

Founder: $25,000 Partner: $10,000 Pioneer: $5,000 Star: $2,500
Gold Club: $1,000 Blue Club: $500 Friend: $100 Other: $

I will make my donation by check credit card.

My/Our gift is eligible for matching fund's through   my   my spouse's  company.
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I wish to make this donation anonymously.

I wish to make this donation in honor of   in memory of   .

Please send acknowledgement to (name and address):

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The official registration and financial information of the Academy In Manayunk can be obtained from the PA Department of State by calling toll-free within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement.