SECURE PLEDGE FORM
Thank you for contributing to the Claude Kistler Legacy Fund
Your information is safe. It will be used only for Friends of KSPS purposes.
Canadians, please enter your 2-digit province code under "State." Thanks!
First and Last Name
Company Name
Address
City State/Province Zip/Postal
Phone Number
Email Address
If you know your member number, please enter it here. (Not necessary but helpful.)
Amount of Gift
Please select an amount.






Please specify amount:
Payment Info
If you pay by credit card, your first payment will be charged now. To delay a credit card payment choose to pay by check/cheque.
Canadians will be charged in Canadian funds.

Change Number of Months
Messages
Optional: Would you like to include a message from you to Claude? Write it here and we will include it in scrapbook we're creating for him.
Is there anything else you'd like us to know?
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