2016 FORM #17 Imagine No Malaria Pledge Form Instructions: Complete all information below, including the amounts already given and remaining to pledge. Both the Pastor and Lay Leader should sign the form. Return a copy to the District Office by the date of the charge conference, if not completed at previous year's charge. STILL TO RAISE: $ ALREADY GIVEN: TOTAL CONTRIBUTION: $ $ Church Name: ______________________________ District:__ _____________ Local Church Organizer: Organizer Email: Organizer Phone: We, , commit to the following: Goal Amount: Goal Length: Save 5,000 lives / $50,000 Save 250 lives / $2,500 Save 1,000 lives / $10,000 Save 100 lives / $1,000 Save 500 lives / $5,000 Other: _____________ 1 years 3 years Other: ___________________ Payments will be sent to: California-Pacific Conference, PO Box 6006, Pasadena CA 91102-6006 with Imagine No Malaria in memo. Monthly Quarterly Annually Other ____________________ _________________________________ _______________________________ Pastor-in-Charge Signature Lay Leader Signature This goal will be fulfilled from the following sources (include amounts if applicable or known): Church finances (budget, endowment, etc) $________________________ Member support (individual gifts and pledges) $________________________ To learn more about Imagine No Malaria in the California-Pacific Conference and to request resources, contact: Imagine No Malaria Field Coordinator California-Pacific Conference (626) 263-0175 // www.buzzkills.net $10 saves a life. How many lives can you save? Text MALARIA CP to 27722 now to make a $10 donation. www.ImagineNoMalaria.org 100% of all funds donated will support the programs and services of Imagine No Malaria. All gifts are tax-deductible to the extent allowed by law.