Outdoor Pool Pledge Form

2. Date
   Date
4. First Name
5. Last Name
7. Street Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Email Address
16. Please list the names that should be used for acknowledgement of donation.
17. Do you want to make an anonymous donation?

    1. Yes
    2. No
19. Pledge Amount
20. Payment Schedule

    Donations can be made in one-time payments, monthly payments for up to 36-months, or annual payments for up to 36-months. Please select your payment preference.

    1. One-time payment
    2. Monthly payments
    3. Annual payments
22. Thank you!
    Thank you for contribution to the Pierre Outdoor Pool! The City of Pierre will contact you in the near future to confirm donation and payment method. For more information, contact City Finance Director Twila Hight at 605.773.3063.
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field