Pontifical College Josephinum Rectors Circle Donation Form "*" indicates required fields Step 1 of 2 50% I am inspired to enroll/ pledge to join the Rector’s Circle giving society, the most sustainable group of benefactors of our mission to form holy, generous, adaptable, and resilient priests for the 21st century to strive for sainthood and help others strive. I was inspired to join because of the*Fall AppealMy relationship with an ordained alumniMy relationship with a lay alumniPersonal Invitation from an advocate or staff memberName of Ordained Alumni Name of Lay Alumni Name of Advocate or Staff member Tier Enrollment Donation Amounts*Please select one of the following tiers below: Tier I ($1,500 - $4,9999) Tier II ($5,000 - $14,999) Tier III ($15,000 - $24,999) Tier IV ($25,000+) Full Enrollment: Fully enroll as a Rector’s Circle by making a qualifying gift to bring you into one of the various tier thresholds. (Tier I-$1,500; Tier II- $5,000; Tier III- $15,000; Tier IV- $25,000+). Split Gifts: Pledge to enroll as a Rector’s Circle member by splitting my gift over the Fall Appeal and St. Joseph’s Appeal. (Tier I- $750; Tier II- $2,500; Tier III- $7,500; Tier IV- $12,500). Monthly Recurring Gifts: Pledge and automatically enroll as a Rector’s Circle Member by giving a monthly gift. (Tier I- $125; Tier II- $417; Tier III- $1,250; Tier IV- $2,084). Tier I Enrollment OptionsFull EnrollmentSplit GiftsMonthly Recurring GiftsTier II Enrollment OptionsFull EnrollmentSplit GiftsMonthly Recurring GiftsTier III Enrollment OptionsFull EnrollmentSplit GiftsMonthly Recurring GiftsTier IV Enrollment OptionsFull EnrollmentSplit GiftsMonthly Recurring GiftsWe are grateful for your desire to enroll in Tier I of the Rector's Circle by fully enrolling. Please fill in the below contact information and payment form upon receipt of your full gift. We are grateful for your desire to enroll in Tier II of the Rector's Circle by fully enrolling. Please fill in the below contact information and payment form upon receipt of your full gift. We are grateful for your desire to enroll in Tier III of the Rector's Circle by fully enrolling. Please fill in the below contact information and payment form upon receipt of your full gift. We are grateful for your desire to enroll in Tier IV of the Rector's Circle by fully enrolling. Please fill in the below contact information and payment form upon receipt of your full gift. We are grateful for your desire to enroll in Tier I of the Rector's Circle by splitting your gifts. Please fill in the below contact information and payment form upon receipt of your pledge to split your giving. We are grateful for your desire to enroll in Tier II of the Rector's Circle by splitting your gifts. Please fill in the below contact information and payment form upon receipt of your pledge to split your giving.We are grateful for your desire to enroll in Tier III of the Rector's Circle by splitting your gifts. Please fill in the below contact information and payment form upon receipt of your pledge to split your giving. We are grateful for your desire to enroll in Tier IV of the Rector's Circle by splitting your gifts. Please fill in the below contact information and payment form upon receipt of your pledge to split your giving. We are grateful for your desire to enroll in Tier I of the Rector's Circle by pledging a monthly recurring gift. Please fill in the below contact information and payment form upon receipt of your pledge to give on a monthly recurring basis. We are grateful for your desire to enroll in Tier II of the Rector's Circle by pledging a monthly recurring gift. Please fill in the below contact information and payment form upon receipt of your pledge to give on a monthly recurring basis. We are grateful for your desire to enroll in Tier III of the Rector's Circle by pledging a monthly recurring gift. Please fill in the below contact information and payment form upon receipt of your pledge to give on a monthly recurring basis. We are grateful for your desire to enroll in Tier IV of the Rector's Circle by pledging a monthly recurring gift. Please fill in the below contact information and payment form upon receipt of your pledge to give on a monthly recurring basis. Rector's Circle Member InformationName* Prefix Mrs.MissMs.Mr.Rev.Very Rev.Rev. Msgr.Most Rev.Dr.Prof. First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone*Email* Home Diocese Home Parish Company Match?Some companies will match donations made. Is this something available to you? My company will match this donation Company Name Additional Information I prefer to make this donation anonymously Would you like to include your spouse's name with this gift? Yes Spouse's Name Based on your selected tier and enrollment method, please provide payment information for the following Rector’s Circle enrolling gift: Rector's Circle Tier Full Enrollment Split Gifts Monthly Recurring Gifts Tier I - $1,500 $1,500 $750 $125 Tier II - $5,000 $5,000 $2,500 $417 Tier III - $15,000 $15,000 $7,500 $1,250 Tier IV - $25,000 $25,000 $12,500 $2084 Today's Total Donation: Billing InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Payment Options Credit Card Checking/Savings Account Credit Card DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Checking Account Name on Account Bank Name Routing Number Account Number Account TypeCheckingSavings
