Pledge Form
The Juniper School
3 Ways to Donate to the Start-Up Efforts of The Juniper School:
1. Donations requiring Tax Deduction: Fill out this pledge form. Checks or money orders made out to CLCS
(Memo: The Juniper School) as instructed below.
2. Donations NOT requiring Tax Deductions: Fill out this form. Checks or money orders made out to The Juniper
School.
3. Donations requesting to be made in person: Email us at durangoschoolsofchoice@gmail.com and we will
make a time to meet.
All Donations can be sent to: Juniper School/DSoC/PO Box 655/Durango, CO/81302
Donor Information:
Name
Billing address
City, ST Zip Code
Phone 1 | Phone 2
Fax | Email
Pledge Information
I (we) pledge a total of $____________________ to be paid: ☐now ☐monthly ☐quarterly ☐yearly. Start Date____________
I (we) plan to make this contribution in the form of: ☐cash ☐check
Gift will be matched by (company/family/foundation)
☐form enclosed ☐form will be forwarded (within 7 business days)
☐I (we) wish to have our gift remain anonymous.
Acknowledgement Information
Please use the following name(s) in all acknowledgements:
Signature(s)
Date
Please make checks, corporate matches,
or other gifts payable to:
Colorado League of Charter Schools
For Questions contact: durangoschoolsofchoice@gmail.com
Durango, CO 81302
Memo Line: DSoC/Juniper School
PO Box 655
----------------------------------------------------Receipt of Donation-------------------------------------------------------RETAIN THIS COPY AS PROOF OF YOUR DONATION UNTIL YOU RECEIVE OFFICIAL RECEIPT FROM THE COLORADO LEAGUE
OF CHARTER SCHOOLS
Name of Donor:____________________________________ Date of Donation:____________________________
Amount Donated:________________________________ Organization donated to: Durango Schools of Choice and The Juniper School