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Pledge Form
AAO Foundation Contest Unmask the Mystery Host at the “Phantom of the Opera” Gala (Please fax to 314/993-5208 or mail to the AAO Foundation)
Yes, I pledge/increase my pledge* to the AAOF Endowment Campaign, A CASE FOR THE FUTURE, to the following over the next ___ three, ___ four, or ___ five years:
___ Founder - $100,000 ___ Fellow - $50,000 ___ Regent - $25,000 ___ Mentor - $17,500 ___ Benefactor - $10,000 ___ Patron - $7,500 ___ Supporter - $5,000 ___ Your Case Fee ($_________)
In as much as individuals pledging at the Regent level or higher have up to ten (10) years to redeem their pledges, I would like for my pledge at this level to be over ___ (number) years.
Please begin sending pledge statements in _____ (Month) _____ (Year).
Please credit the following person, for the purposes of the Gala Contest, as being responsible for my pledge/pledge increase: ___ Myself ___ Name(s) of Person(s) to be Credited: _______________________________
I prefer instead that the AAOF bill me $___________ each year (e.g., $5,000 for a case annually, or $2,500 for a case every other year), with reminders to be sent (choose one) quarterly (___) or annually (___).
Please make one of the following two designations: ____ Please restrict my gift solely to the Endowment Fund. ____ You may use my gift for orthodontic education and operational expenses at the discretion of the AAO Foundation Board of Directors.
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