Vision 2023 Pledge / Donation Form ~01

email: Vision2023@myhtw.net, Phone: (713) 724-5830 (Jagan Allam) or (832) 515-9852 (Lalitha Koduru)

Please send checks to Hindu Temple of The Woodlands, PO Box 130307, Spring, TX 77393

Your Contact Information

First Name *

Last Name *

Email *

Address Line 1 *

Address Line 2

Phone

City *

State *

Zip *

I would like to pledge the following amounts towards HTW Vision 2023 project:

(All amounts paid between Sep 2019 to Dec 2026 will be applied towards this pledge)

Level 1: $3,000 ($51/month * 60 months)

Level 2: $10,000 ($167/month * 60 months)

Level 3: $25,000

Level 4: $50,000

Level 5: $100,000

Level 6: $250,000

Other Amount The field Other Amount must be a number.

Will donate using securities (stocks, bond, etc.)

My company has a matching grant program

Recurring Frequency

Recurring Count

Recurring Installment Amt (each) The field Recurring Installment Amt (each) must be a number.

Pay By Check

My billing information is the same as my contact information.

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State *

State/Province

Zip *

Credit Card Number *

CVV Number * What is this?

Credit Card Type *

Expiration Month *

Expiration Year *