Charitable Giving Form Charitable Giving Form Donor Information State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Making A General Contribution This contribution is: General contribution to be directed to: Rejuvenate Capital Campaign Wick Endowment Fund Resident Scholarship Fund Glenn & E. Janet Powell Endowment Fund Sears Methodist Assistance Fund Unrestricted Gift Other Joining The Legacy Society I/we want to join Legacy Society and have/will make provisions for the Meth-Wick Endowment Fund through a planned gift: Will/Bequest Charitable Gift Annuity Other Joining The Heritage Circle I/we will make a commitment to join Heritage Circle through a current gift/pledge: —Please choose an option—Founders Level ($30,000+ or pledge of $10,000+ annually for 3 consecutive years)Benefactors Level ($15,000 – $29,999 or pledge of $5,000 – $9,999 annually for 3 consecutive years)Patrons Level ($7,500 – $14,999 or pledge of $2,500 – $4,999 annually for 3 consecutive years)Friends Level ($4,500 – $7,499 or pledge of $1,500 – $2,499 annually for 3 consecutive years) Total amount pledged: Payment dates: For More Information Yes, I would like to know more about charitable gift annuities Yes, please contact me about other types of charitable giving opportunities Questions? Contact Robin Mixdorf, (319) 297-8601. After completing the form above, please click the “Send” button to be advanced to complete payment via Paypal.