On this _______________ day of ___________________, 20___, I/we, agree to contribute and hereby pledge to the United Way of South Hampton Roads Foundation (The Foundation) (or name of an affiliate) the sum of ____________________________________.

I/we agree to make future contributions, either in lump sum or in installments for the purpose of satisfying this pledge and further agree that this pledge will be satisfied in full by________________. The Foundation agrees that it will apply the contributions in accordance with its tax exempt purposes and will enter my/our name(s) on the Foundation's contributor's list. I/we consider the entry of my/our name(s) on such list a valuable benefit. It is my/our intent in entering into this Pledge Agreement that the Foundation rely on this pledge for its budgeting, planning, and other related activities; and this pledge shall be contractually binding upon me/us, my/our estate(s) and assigns.

IN WITNESS THEREOF, I/we have entered into this Pledge Agreement on the date stated above and the Executive Director of the Foundation has entered his signature to this Pledge Agreement.

Name

Agency: _______________________________

By: _______________________________


Name

United Way of South Hampton Roads Foundation

By: ____________________________________
              Michael Hughes, Executive Director