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Print this form if you would like to
mail your gift or pledge.
I/we wish to
support Ele's Place by making a gift in the amount of: $__________
My/our total gift
will be paid as indicated:
 A Check payable to
Ele's Place
A credit card
charge to: (circle one)
MasterCard
Visa
Card number:
________________________________
Expiration date:
_______________________________
Name on card:
________________________________
A pledge of $1,000
over 12 months, qualifying me for Ele Club
benefits.
Enclosed is my/our first pledge payment of: $ _________
Send pledge reminders: (circle one)
Annually
Quarterly
This is a
joint gift with my spouse (name) ___________________________________, or
This gift
should be credited to my individual record.
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I/We understand
that publishing supporter names often encourages others to give.
Therefore, Ele's Place may include me/us in donor recognition under the following
name(s):_____________________________________
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I/We prefer that
my/our gift is not recognized.
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Personal Information:
Name:
______________________________ Date: _______________
Address:
____________________________
City:
______________ State: ______ Zip:
___________
Daytime phone:
( )______________________
Evening phone:
( )_______________________
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I'd like
information on how to make a gift of stock to Ele's Place.
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I'd like
information on making a planned gift to Ele's Place.
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I'd like
information on making a gift to the Ele's Place Endowment Fund.
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Ele's
Place
1145 W. Oakland
Lansing, MI 48915
517-482-1315
healing@elesplace.org
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