LEADERSHIP GEORGIA ENDOWMENT PLEDGE CARD

PLEASE PRINT AND FAX OR MAIL THIS FORM TO OUR OFFICE AT:
Leadership Georgia 233 Peachtree St., Suite 2000, Atlanta, GA 30303
Fax: 404.223.2290

Yes!  I/we want to support Leadership Georgia with a gift to the $1.5
million endowment campaign.   Pledge Amount (may be paid over three
years):  $______________  

Optional Recognition Levels Include: 

___Chairman's Circle $25,000    ___Leadership Circle $3,000    ___Other
___President's Circle $7,500      ___Fanning Circle $1,500 

Payment Schedule:  
______ Full payment enclosed  

______ Payment made annually in installments of  $_____________    

______ I would like to pledge a gift of stock. Send me transfer information.  

______ Please charge my:  _____AMEX  _____Mastercard  _____Visa  

Card Number: ________________________   Exp. Date: ____/_____

Name as it appears on card: _______________________________  

My gift will be matched by: _________________________________    

Name(s):__________________________________________                            
              (List name as it should appear for recognition purposes) 

Address: _____________________________________________________  

City:______________________  State:____________  Zip Code:_________  

Telephone: __________________  E-mail:____________________________  

Please indicate Leadership Georgia Class Year: ___________________  

_____ Please contact me to include Leadership Georgia in my estate plans.