Donations – Pledge Form

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Below is a donation form that can be filled out online, or printed and mailed with payment. If you are donating online, please fill out the secure form below and click on the “Send” button. If you would like to mail your donation, please fill out form, print the form, and mail with donation to:

Cincinnati Association for the Blind and Visually Impaired
2045 Gilbert Avenue
Cincinnati, OH 45202

Please direct questions to Kathy Gottschlich, director of development and community relations, at 513-487-4233 or email her at kathy.gottschlich@cincyblind.org. Thank you for your support!

Cincinnati Association for the Blind and Visually Impaired
Pledge of Support

I recognize the valuable services that Cincinnati Association for the Blind and Visually Impaired provides to the Greater Cincinnati area and want to make a pledge/donation to support this organization.

Required Information

*First Name:
*Last Name:
*E-mail:

Pledge Information

I will make a gift of $:
Enclosed is my check in the amount of $
Home Phone Number:
Address:
City:
State:
Zip:
Name (s) as it (they) should appear in the donor listing:
This gift is in memory of :
This gift is in honor of :
Please acknowledge this gift to:
Signature (if mailing form):
Date:
Payment Option:
I will transfer shares of stock:
The estimated stock value is $
I will transfer it in the month of
Comments and Questions:

Submit Information

Thank You!
*This field is required.

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Donations – Pledge Form

Cincinnati Association for the Blind and Visually Impaired Pledge of Support

Cincinnati Association for the Blind and Visually Impaired
Pledge of Support