Contribute to the Discovery Campaign

Discovery Campaign Support Levels

Innovator	$100,000+		Leader	$10,000+
Pioneer	$ 50,000+		Explorer	$ 5,000+
Pacesetter	$ 25,000+		Voyager	$ 2,500+
	Sponsor	Up to $2,499

Discovery Campaign Pledge Commitment Form

I wish to make a commitment in support of the goals of the SIR Foundation Capital Campaign. My total pledge is $ ($ per year for years), to be paid on the following schedule:

$ in / (month/year)

$ in / (month/year)

$ in / (month/year)

$ in / (month/year)

$ in / (month/year)

Please send reminder notices in the month(s) of

Special Notes:

Name:
Address:
City, State and Zip Code:
Email address:
Date:
Name(s) you prefer for gift recognition:
Phone number:

Please check if you wish your gift to be Anonymous:
My employer will match my Campaign commitment:

By checking this box I agree to make contributions to the
SIR Foundation Discovery Campaign as outlined above.

If you would prefer to mail or fax this form, a PDF is available here.

Please make all checks payable to SIR Foundation.

SIR Foundation is a 501(c)(3) organization.
Your gift may be tax-deductible according to IRS regulations.