ACS - Pledge Sheet - 1

For ACS use only: Total Funds Collected: ____________ Verified by: _____________________ Signature: ______________________

Name: _______________________________________________ Team Name (if applicable): ________________________________ Address: _____________________________________________ City, State, Zip: __________________________________________ Phone: _______________________________________________ Email: _________________________________________________ Name

Address

City, State, Zip

Phone

Email

Pledge Amount

1.

2.

3.

4.

5.

6.

7.

8. * Checks should be made payable to the “Animal Care Sanctuary” Page 1 Subtotal: ________________ Page 2 Subtotal: ________________ Online Subtotal: ________________ Grand Total: ___________________