Pledge Form I/we pledge to support Kaleideum with a total gift of*Payable over*(up to 5) yearsBeginning on*Signature*Donor(s) Name Printed* First Last Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Number*PaymentForms of Payment* I will pay by check (payable to Kaleideum) Please charge my Credit Card: Name*Name as it appears on cardCredit Card #*Name as it appears in cardExpiration* Kaleideum Attn: Development 400 W. Hanes Mill Road Winston-Salem, NC 27105 Kaleideum will send a pledge reminder onemonth before the payment is due.* Please contact me about a gift of stock, insurance or other gift type. This donation is eligible for a matching gift Company Name*Needed for matching gift