I pledge the sum of:   $ ________;

I would like to make my pledge in one payment _  or  in monthly payments _;

I pledge the amount above for year 2001 _ ; for year 2002 _;  for year 2003 _.

I understand that this pledge will be called upon when the funds are needed.  I will be notified at least 21 days prior to actual funds being required. When I honour my pledge, a charitable tax receipt will be issued.

Name (please print):
 
Address:

City:                                        Province:                        Postal Code:

Telephone:                              Fax:

Signature:                                  Date:

Please fax completed form to: 537-2681, mail to above address, or drop in box at the Island Savings Credit Union information desk.
If you wish your pledge to be anonymous, please check here _ and fax or mail this form directly to the address below.

TLC-THE LAND CONSERVANCY OF BRITISH COLUMBIA
5793 Old West Saanich Road, Victoria, BC, V9E 2H2
PHONE:  (250) 479-8053  FAX:  (250) 744-2251   email:  admin@conservancy.bc.ca  www.conservancy.bc.ca
Registered Charity Number: The Land Conservancy of British Columbia: 88902-8338 RR0001