Pennybyrn at Maryfield
Annual Giving Opportunities

This gift is made in honor or in memory of ________________________________.
Please notify _______________________ at ______________________________.
I/We pledge $ _________________. Please find the enclosed check for $___________.
(Balance to be paid by the close of our fiscal year, September 30.)
Please charge my _______ Visa _________ Mastercard
Exp. Date ________
Card. No. ______________________ Signature ______________________
(Select your level of giving)
____ Founder’s Society Member - $2,500 +
____ Honorary Trustee - $1,000 - $2499
____ Sister’s Council - $500 - $999
____ Benefactor - $250 - $499
____ Patron - $100 - $249
____ Sponsor – to $99

Name: _______________________________________________________________
Address: _____________________________________________________________
City: _______________________________________State: ____Zip Code: ________
Telephone: ____________________________________
E-mail: _______________________________________
__ My company will match this gift, Company name: _______________________________.

**Please make checks payable to Maryfield, Inc.
109 Penny Road, High Point, NC 27260
Maryfield, Inc. is a non-profit 501(c)3 organization. (Fed. ID: 58-1363950)