BPI Gift Commitment Form

BPI Gift Commitment Form
I/we wish to support the work of the Black Philanthropy Initiative and make the following commitment:
A total gift of $ total gift amount* to the Black Philanthropy Initiative Fund. This commitment will be fulfilled as follows:
Please select all that apply
My one-time contribution will be made by the following date:
enter date above
For my one-time contribution, I will:

Other
My multi-year commitment will be payable over
First payment of $ first payment amount will be made by the following date: Date . (Please note: Pledge reminders are sent annually in October.)
Please send me an annual pledge reminder.
My multi-year grant payable from my/our donor-advised fund at The Winston-Salem Foundation will be payable over
Fund Name
Please schedule these grants from my donor-advised fund with the first payment on month year
Please schedule this one-time grant from my donor-advised fund with the payment on month year
Contact Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How do you self-identify? (optional)

Different identity (please specify)
Should be Empty:

Contact Information