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Donation form

Name ________________________________________________________________________

Address ______________________________________________________________________

Phone __________________________________        Fax ______________________________ 

Email _____________________________________________ 

I am designating my gift for the:

    Endowed Fund (Only investment income is distributed.  Your gift remains to continue earning.)

    Current Program Fund (To be used for current programs.)

I am choosing the following type of gift:

    One-time gift of $_______________ .

    Installment payments of $__________________  each, on the __________ day of every ____________ (month, quarter, or year), to begin ____/____/____  and end ____/____/____ .

    Memorial or  Honorarium - in memory/honor of _________________________________ .  Amount $_____________ .  Please send acknowledgement to: (print name & address) ______________ ______________________________________________________________________________ .

    Matching gift.  Enclosed is my gift of $______________  which will be matched by my employer, 

(print name & address) _______________________________________________________________ .

Please collect my gift by the following method:

    Check enclosed.  (Payable to The Bedford Area Educational Foundation.)

    Debit my bank account.  (Enclose a blank, voided check or deposit slip and sign below.)

            Name of Bank ___________________________________________ 

            Account # _______________________________   Type of account ______________ 

    Charge my credit card.    Visa    MasterCard

            Name on card (please print) ______________________________________________ 

            Card # _____________________________________   Expiration date ____________ 

My signature below hereby authorizes the Foundation to debit my account/credit card as indicated by me on this form.  

Signed ______________________________________   Date _________________

Please contact me about establishing a:

    Gift of Securities      Bequest      Charitable Gift Annuity

Comments:  _________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

The Bedford Area Educational Foundation is a 501(c)(3) non-profit organization.  Contributions are confidential and tax deductible.

If you have any questions, please call 540-587-8744 or email info@bedfordeducation.com.

To submit your donation, print this page, complete the information, sign, and return to