Giving Tuesday Matching Challenge Pledge Form

I/We pledge to donate, joining other individuals or companies in creating a matching fund challenge as part of Sustainable Health Empowerment’s Giving Tuesday campaign on December 3, 2019. I/We understand that this amount will be charged to the credit card indicated below as one lump sum on December 3 or in twelve monthly increments, if preferred.

Name *
Name
Billing Address *
Billing Address
Phone Number *
Phone Number
$
Payment option *
Please acknowledge me/us by