Contributions to NCS and Treetops, a 501(c)3 non-profit, are tax deductible to the full extent of the law. For stock or wire transfer instructions please contact kterrell@ncstreetops.org

Please return to North Country School and Camp Treetops • Advancement Office

4382 Cascade Road • Lake Placid, NY 12946 • Ph 518-523-9329 • Fax 518-523-4129 www.northcountryschool.org • www.camptreetops.org

Ei leen Rockefeller’s Challenge We, ___________________________________________, are pleased to make a generous pledge of $_________________________ for Eileen Rockefeller’s

Challenge to grow Annual Fund, preserve Round Lake, and build the Richard Rockefeller Fresh Start Scholarship

Endowment Fund.

We will fulfill our commitment with installments of $_________________________ for each of the next _____ (no more than 5) years

ending August 31 of 2016, 2017, 2018, 2019, and 2020.

Please indicate how you want each year’s gift to be used (please select only one).

£ Use as needed to grow Annual Fund, preserve Round Lake, and build the Richard Rockefeller Fresh Start Scholarship Endowment Fund.

or

£ Use as follows:

$_____________________ to grow Annual Fund, $_____________________ to preserve Round Lake, and

$_____________________ to build Richard Rockefeller Fresh Start Scholarship Endowment Fund.

We understand that the institution, on behalf of its auditors, may contact me to confirm my pledge and to remind me

of the fulfillment schedule.

_______________________________________________________________________________________________________________________________________________________________ Donor(s) Signature(s) Date

First payment deta i ls (optiona l)

£ My/our first installment of $____________________ is enclosed (optional)

£ Please charge my/our first installment to: £Visa £MasterCard £American Express

Card number _________________________________________________________________________________Exp Date ___________________ Security Code _______________

Signature_____________________________________________________________________________________________________________________________________________________________________