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How you can help Sending your support Vineyard House, Inc.
Capital Campaign Pledge Form
P.O. Box 4599 Vineyard Haven, MA 02568
508-693-8580
Email: vineyardhouse@vineyard.net
Web Site www.vineyardhouse.org
Name________________________________________________________________
Island Address ______________________________________phone ___________
Off-Island Address ___________________________________phone ___________
Email Address ________________________________________________________
In support of the Vineyard House Capital Campaign to build a replacement facility,
I/we hereby pledge the following $ ________________________________________
To be designated as follows: (check one)
____ Construction project ____ Operations, including administrative costs
____ Where most needed
Pledge date: ________________________
As of _______________ we have paid $ _______________________
We plan to pay the remaining $ ________________according to the following schedule:
To be paid over _____ years starting _________________.
Please remind me as follows_____________________________________________________
Note re donated securities: Gifts of securities can be made through your broker to our investment account at Merrill Lynch (One Citizens Plaza, Suite 1000, Providence, R.I. 02903) DTC 5198, Account # 86702215, (phone 800-937-0710). All securities are sold immediately upon their receipt into our account. Please inform Vineyard House separately at the time of your gift, as the securities may arrive without identification as to the original owner.
Signature Date
Vineyard House is a 501 (c)(3) charitable organization, EIN # 04-3374-934
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