Annual Support Pledge Form

Thank you for your support! Please fill out the fields below so we can officially record your contribution and provide you with an invoice.

Pledge Details

Company Name *

(Enter your company name as you would like it to be listed in our Annual Report)

Dollar Amount Pledged *

Invoice and Payment Information

I will provide a Purchase Order (PO) number

I need an invoice submitted through a payment platform

Please indicate if you will pay in one lump sum or multiple payments

One lump sum

Multiple payments

Multiple Invoices

I will require multiple invoices

Payment method

Wire transfer (Ad Council's preferred method)

Check

Month of Expected Pledge Payment *

July 2023

August 2023

September 2023

October 2023

November 2023

December 2023

January 2024

February 2024

March 2024

April 2024

May 2024

June 2024

Please note the Ad Council's fiscal year runs from 7/1 - 6/30. Payment can be made any time prior to the close of our fiscal year.

Your Contact Information

First Name *

Last Name *

Title *

Address

Address 1

Address 2

City

State

Zip

Email Address *

Daytime Phone *

Contact Information for Invoice

Is the contact information for the invoice the same as above? *

Yes

First Name *

Last Name *

Title *

Mailing Address *

Mailing Address

Address 1

Address 2

City

State

Zip

Daytime Phone *

Email Address *

Please confirm that you are authorized to make this pledge. *

I am authorized by the organization above to make this pledge.

If you are human, leave this field blank.

The Ad Council is a private, not-for-profit 501(c)3 organization. Our tax ID is #13-0417693.

Contributions are tax-deductible to the fullest extent possible allowed by law.

Questions? Please contact pledge@adcouncil.org or 212-808-1520.