Bethel Historical Society Capital Campaign Donation/Pledge Form

Name: __________________________________________________________

Street Address / P.O. Box: _________________________________________

City / Town: __________________________   State: ___________________________    Zip Code: __________________________

Telephone: ___________________________    Fax: ____________________________    Email: ____________________________

I would like more information about Robinson House naming opportunities.  Please contact me (circle one) in writing / by telephone / by e-mail.

I am enclosing a gift in the amount of $______ in support of the Bethel Historical Society's Capital Campaign.

I will pledge $______ to be paid as follows: ______________________________________________________________________________________

I would like this donation to be named (circle one) in honor / in memory of: ____________________________________________________________

Please print out this form and mail to the Bethel Historical Society at P.O. Box 12, Bethel, ME 04217-0012

Gifts made to the Bethel Historical Society are deductible for federal income tax purposes within the limits of the Internal Revenue Code
and, in many cases, will allow us to receive matching gifts.  Thank you in advance for your generous support!