Pledge Form

Our fiscal year ends on June 30. Pledge reminders will be mailed periodically.

Please fill in the form to make your on-line pledge. Fields in bold are required.

First Name:
Maiden/Middle Name:
Last Name:
Street Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Email Address:
Class Year (if applicable):
Pledge Amount:
Allocation:	Longwood Fund Connelly Scholarship Endowment Other Please specify:
Questions or Comments:
I have included Longwood in my will.
I would like information on Estate Planning.

Longwood University