/SECUFPledgeForm

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Southeastern Credit Union Foundation Pledge Form Pledge from (select one): ________ Credit Union/Company/Organization ________ Individual – personal donation Please use our contribution in the following way(s): All-Purpose Fund ……………………………………………………………………………. $______________ Provides educational scholarships for credit union staff and officials for professional development and grants to related organizations focused on professional development, financial education and industry specific research.

Disaster Relief Fund ………………………………………………………………………… $_______________ Provides immediate assistance to credit unions, staff, volunteers and communities impacted by natural disasters.

Credit Union for Kids Contribution ..…………………..……………………………………. $_______________ Provides funding to Children’s Miracle Network hospitals serving credit union communities in Alabama and Florida. These contributions are used to support research and training, purchase equipment, and pay for uncompensated care, all in support of CMN’s mission to save to improve the lives of as many children as possible.

Amount Enclosed

$_______________

Name:______________________________________________________________________ Credit Union:_________________________________________________________________ Address:_____________________________________________________________________ City:_________________________ State:______ Zip:________ Chapter:_______________ Payment Options ACH to SECUF Disaster Relief Fund

ABA #: 263182516

Account#: 9120000132522

Check Thanks to YOU for your continued support. The Southeastern Credit Union Foundation will be recognizing all donors on the SE CU Foundation website and at the LSCU AC&E.

Submit to us directly Florida Commerce Credit Union 1620 Futura Dr. Suite 100 Tallahassee, FL 32317 C/O Southeastern Credit Union Foundation FAX: 850.558.1155


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