Submit Pledge

1. Due Date: Enter the Date you plan to clear your Total Pledge.
2. Mode of Pledge Payment:

3. Currency:

4. Amount: Enter your Total Pledge here and Installments in No. 10 below.

5. Contributer Full Name: (Yours) Including Salutation - Bsp | Dr | Mr | Ms | etc

6. Contributer Email: (Yours)

7. Contributer Phone: (Yours) No dashes, spaces or other funny characters.

8. Recipient Email: (The Other Person)

9. Recipient Phone: (The Other Person) No dashes, spaces or other funny characters.

10. Particulars: What is this Pledge for? Installments Amounts and Dates of Lumpsum Pledge? Any Comments?

11. Template:

12. Entry Date: Thursday, 23rd May 2019 08:41:23 (Germany Server Time)

ReCAPTCHA: Tick here to confirm you are human

NOTE: If ReCAPTCHA displayed a "I'm not a robot" box above and you tap there, kindly wait until your tick appears before you hit Submit Pledge.

To guide your Audience here, communicate to them as such: "Kindly register your Pledge via M-Shirika Fund Raiser [www.mshirika.com] Email: me@gmail.com Phone: XXXX XXX XXX". Provide your Email and Phone. Once submitted, an Automated E-Pledge Receipt is sent to both the Contributer and Recipient either of whom may complete this Form. Your Pledges Report is also tabulated below as Private and Confidential upon Login wherein SMS Confirmations may be sent from.

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