• The maximum number of form submissions has been reached. This form is currently not available.

  • Salutation REQUIRED (Select One) Deacon Deacon & Mrs. Dr. & Mrs. Drs. Fr. Miss Mr. Mr. & Dr. Mr. & Mrs. Mrs. Ms. Sr. Please fill out this field.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Spouse Please enter valid data.
  • Registered Parishioner? Yes No Don't Know
  • Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Spouse's Phone Number Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Spouse's Email Please enter valid data.
  • 3-year Pledge, Monthly(M), Quarterly(Q), Semi-Annual(SA), Annual(A) REQUIRED $500,000   (M)$13,888.89  (Q)$41,666.67  (SA)$83,333.33  (A)166,666.67 $250,000   (M)$6,944.44  (Q)$20,833.33  (SA)$41,666.67  (A)83,333.33 $100,000   (M)$2,777.78   (Q)$8,333.33  (SA)$16,666.67  (A)33,333.33 $50,000   (M)$1,388.89  (Q)$4,166.67  (SA)$8,333.33  (A)16,666.67 $30,000   (M)$833.33  (Q)2,500  (SA)$5,000  (A)$10,000 $15,000   (M)$416,67   (Q)$1,250  (SA)$2,500  (A)$5,000 $7,500    (M)$208.33   (Q)$625   (SA)$1,250   (A)$2,500 $3,000    (M)$83.33    (Q)$250   (SA)$500    (A)$1,000 $1,800    (M)$50   (Q)$150   (SA)$300   (A)600 Other 3-year Commitment Please fill out this field.
  • Other 3-year Commitment/Gift Amount:

    Total commitment amount over 3 years, if "Other"

    Please enter valid data.
  • Please send me reminders Monthly Quarterly Semiannually Annually One-Time
  • Date of First Payment

    When would you like to make your first payment? Three-year pledge period starts when your first payment is made.

    Please enter valid data.
  • Matching Gift option My gift will be matched by my company.
  • Company Please enter valid data.
  • Method of Payment REQUIRED Cash/Check (Payable to "St. Martha Catholic Church" with "Capital Campaign" in the memo line Stock/Life Insurance (The St. Martha office staff will contact you for additional information) Online giving through Faith Direct Other: (fill out below) Please fill out this field.
  • Other method of payment: Please enter valid data.
  • Electronic Signature REQUIRED Please fill out this field. Please enter valid data.
  • Date REQUIRED Please fill out this field. Please enter a date.
  • Please print your name as you would like it to appear in any campaign recognition materials: REQUIRED Please fill out this field. Please enter valid data.
  • I/We would like our gift to remain anonymous. Yes
  • Do you have any prayer requests we can pray for? Please enter valid data.

  Submit