Antioch College Alumni Association

Online Pledge Form

Antioch College Continuation Corporation
as agent for the College Revival Fund, Inc.

This is a Pledge. You will only be billed at the date(s) you specify.

First Name

Last Name

Mailing Address

Phone Number

Pledge Amount(s)

Pledge 1

Pledge 2

Pledge 3

Pledge Amount(s) 4

Pledge Amount(s) 5

Make sure you include dates for payment or your pledge won't count!

Date for payment on pledge 1:

Date for payment on pledge 2

Date for payment on pledge 3

Date for payment on pledge 4

Date for payment on pledge 5

1. I hereby state my intent to make the gift set forth above to the College Revival Fund (CRF) upon the condition that final and definitive agreement(s) are established for the independence of Antioch College to the satisfaction of the Board Pro Tempore of Antioch College Continuation Corporation (The Board). Once this condition is met, I will distribute this gift to the CRF set forth on the schedule set out above.

2. My gift may be used for any and all operational or capital needs associated with the revival of Antioch College as directed by The Board. The principal of my donation may also be invested according to the policies adopted by The Board, and may be comingled with other funds of the CRF for investment purposes.

3. The CRF shall report periodically on such matters as the actual use of and distribution of my donation.

I agree to the above statements regarding my pledge(s). (checking this box constitutes an electronic signature)