Make a Capital Contribution to the YMCA

Thank you for choosing to support the YMCA. Please fill out the following information to let us know how you'd like to give to the YMCA of Southeastern NC.

Contact Information
Name
Organization Name
Address
City
State
Zip
Phone
Email

How I Would Like My Gift Recognized
 I would like my donation to remain anonymous
 I would like my donation made in memory of someone
 I would like my donation made in honor of someone
Individual or family you wish to recognize

Donation Information
I plan to give a total of:
I wish to begin my payments in (month / year)
I wish to spread my donation over
 1 Year
 2 Years
 3 Years
 4 Years
 5 Years

Area of Support
Please share which capital project you wish to support:
Please select your YMCA branch (if applicable)
 Nir Family YMCA
 Midtown YMCA
 YMCA Youth Services
 YMCA Camp Kirkwood
 To the Greatest Area in Need
Named gift opportunity that interests you:
Other notes regarding your donation:

Payment Options
Please select your payment type
 Cash or Check
 Stock
 Credit Card
 Other

Payment Reminders
Please send reminders
 Annually
 Semi-Annually
 Quarterly

Employer Matching Gift
 My company will match my gift

Planned Giving and Endowment Opportunities
 I am interested in learning more about planned giving and endowment opportunities.

Donor Signature
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