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The Unitarian Universalist Meeting House of Provincetown
Keepers of the Flame - The 2012 Stewardship Campaign
This on-line form is designed to receive your 2012 pledge of support to the Meeting House. The information will be confirmed to your email address before it is entered in the Meeting House records. We thank you for your support of the work of the Meeting House
*
Contact information
Contact information
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
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CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
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GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
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ND North Dakota
MP Northern Mariana Islands
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OR Oregon
PW Palau
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TN Tennessee
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UT Utah
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WA Washington
WV West Virginia
WI Wisconsin
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ZIP:
Email Address:
Phone Number:
Pledge to the UUMH
Pledge to the UUMH
My pledge for 2012 is..............$
If you are finishing your 2011 pledge, please indicate that on your check so that it will be credited properly.
Do you wish to have pledge envelopes?
Do you wish to have pledge envelopes?
Yes
No
I/We intend to pay the pledge with stock
I/We intend to pay the pledge with stock
No
Yes
Corporation name
It is understood that it is my/our intent to complete payment of this pledge by December 31, 2012. I/We understand that if circumstances change, the above amount may be revised or canceled by a call to the Treasurer of the Congregation.
The Unitarian Universalist Meeting House
P.O. Box 817
Provincetown, MA 02657-0817
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