Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11100TH ANNIVERSARY CAPITAL CAMPAIGN FOR PROVIDENCE CATHOLIC HIGH SCHOOL Donor Intent Form Yes, I / we would like to make a gift to support the 100th Anniversary Capital Campaign to build a new student commons / cafeteria. PLEDGE INFORMATION I (we) pledge a total of $ Payment:  Now  Over a period of years to be reminded  monthly  quarterly  yearly I (we) plan to make this contribution in the form of:  check  credit card  stock  other Credit card type:  Visa  MasterCard  American Express Credit card number Expiration date Verification number Authorized signature Gift of stock (Name, #, Value) Gift will be matched by (company/family/foundation) Please use the following name(s) in all acknowledgments  I (we) wish to have our gift remain anonymous. Signature(s) Date Please make checks, corporate matches, or other gifts payable to: Providence Catholic High School 1800 West Lincoln Highway New Lenox, IL 60451 Name Address City, State, Zip Preferred Phone Preferred Email Building Our Legacy, Every Student… Every Day