UU Safe Spaces II Pledge Form

Please use this Pledge Form if you are a congregant of the Unitarian Universalist Church of Concord and enter “UU” as the “Referring Organization” in the form below.

Thank you for being a part of the special UU Community Plate dedicated to raising $40,000 (or more) to help CCEH provide essential services to those experiencing homelessness in our community, and work toward the goal of ensuring everyone has a stable, safe, affordable and decent place to call home.

$20,000/$10,000 DOUBLE MATCH CHALLENGE!

A non-UU community member has specifically earmarked up to $20,000 to match donations and pledges made by congregants as part of this special UU outreach effort. And the first $10,000 received will not only be doubled but quadrupled thanks to several generous UUs. In other words, if you donate or pledge $1,000, it gets doubled to $2,000 by internal UU matching donors, which in turn gets doubled to $4,000 by the non-UU Challenge Match Donor.

Your contribution can be made to the “UU Church of Concord” indicating “CCEH” in the memo line, or directly to CCEH. If you are paying on or before November 8, 2020, you can also use the online Community Plate option at concorduu.org/faith-in-action/community-plate/

Your pledges can span three years as long as your pledge amount is paid by June 30, 2023! For example, you might pay $400 in 2020, and $300 in 2021 and 2022 each.

Name *

First

Last

Preferred Name

(Optional)

Email *

Email

Confirm Email

Phone

Mailing Address: *

Pledge Amount: *

TOTAL Pledge Amount

This pledge will be paid *

At one time (enter date below)
In monthly installments over three years (enter start date below)
In quarterly installments over three years (enter start date below)
In annual installments over three years (enter start date below)
Other (enter comments below)

Please be specific about your desired payment schedule.

Start Date for Payments/Other Payment Schedule *

Please be specific about the date of your initial payment, or the specific payment dates and amounts for your pledge.

Signature of Intent to Pledge *

By initialing above, I/(we) convey my/(our) pledge to contribute cash and/or assets in "Pledge Amount" to the Concord Coalition to End Homelessness 3-year Safe Spaces II: The Next Step campaign.

Referring Organization *

Is your pledge a part of a group effort (workplace, church, other organization)? If so, list their name here.

My company will match my donation

YES

Please mail or email your completed company match form to: office@concordhomeless.org OR CCEH, PO Box 3933, Concord, NH 03302

This pledge is made

In honor of
In memory of

Please enter name below.

In honor of/memory of name

Please enter the name of the person you would like to honor with your gift.

Please enter notification Name(s) and Address(es) for your In Memory of/In Honor of donation

CCEH will notify those listed above about your IMO/IHO donation.

CCEH may recognize me and my contribution in printed or electronic materials

YES
NO

Would you like to sign up for CCEH's monthly e-newsletter to read about what CCEH is doing in the community?

YES
NO

You can easily unsubscribe at any time!