NCFADS Scholarship Pledge Form

Name:

First                                                                                            

Middle initial                   

Last                                                                                            

Address:

                                                                                                    

                                                                                                     

City                                                                                             

State                     Zip                                                                 

Day phone                                                                                 

Evening phone                                                                          

Email address                                                                             

I would like to:


Donate to the general scholarship fund (check one):
$25   $50  $100           $               for                  years


Sponsor a named scholarship for $1,000 now and the value of a full-time registration
      adjusted for increased costs per school.


Endow a scholarship for $15,000 to be paid over (check one):
            1 year              2 years             3 years

Payment:

My check will be mailed separate, made payable to NCFADS.

Please contact me about a stock/property pledge.

I wish to pay by credit card.

      Card Type                                                                                       

      Card #:                                                                                             

       Expiration date