CAMPAIGN COMMITMENT FORM   Please Print 

Please indicate:

___Pledge     ___ One Time Gift

NAME:_____________________________________Class_____________

ADDRESS: ___________________________________________________

CITY: _______________________STATE:___________ZIP:____________

Individual RECOGNITION LISTING for the Recognition Plaques

 q Same as aboveq  Please list recognition as follows:

___________________________________________________________________________

Please make checks payable to: Blessed Sacrament Capital Campaign

My/our gift to the Campaign is:

                TOTAL PLEDGE:               _________________

                DOWN PAYMENT:            _________________

            BALANCE DUE:               _________________

_______________________________________________________

FOR OFFICE USE ONLY:

   qCash         qCheck #________     qCharge     qEFT

Date                        Payment                                 Auditor_____ _

Please mail to

Blessed Sacrament Parish

Campaign Form

4227 Bellevue Rd.

Toledo, OH 43613