(Fields marked with * are required.)

Donor #1*




Donor #2




Postal Address*


I/We commit to support UUCV's budget for the fiscal year that begins on July 1, 2018 as follows:

Total amount of pledge for 2018-19 budget year*

Installment payments will be made * * in the amount of .*

Automatic Bill Payment (optional)

By completing the following information, I/we authorize the Unitarian Universalists of the Cumberland Valley (UUCV) to initiate debit entries to the account indicated below, and the financial institution named below to process those entries. Each such debit shall be made in amount and timeframe specified above. This authority shall remain in effect until I notify UUCV in writing, not less than thirty days prior to my next due date.

Financial Institution

ABA Routing Number

Account Number

Give by Credit Card or PayPal (optional)

You may also set up automatic payments by credit card or PayPal by visiting our online donation page. (Because these payments are managed by PayPal and not UUCV, please complete and send the Financial Commitment Form above to notify us of your pledge, separately from the payment setup itself.)

Click here to open the UUCV online donation page in a separate window.