Fundraisers Pledge Form Fundraiser Form This form is to be used during our fundraisers. Name of Donor First Middle Last ProjectsOrphans and WidowsImam al-Hujjah HospitalSchools and EducationSadaqaGeneral CharityPledge Amount Donor E-mail Please provide us with your email so we may send you tax receipts. Phone Number Donor Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please kindly provide us with your address if you would like to receive newsletters to keep up with our latest projects.NameThis field is for validation purposes and should be left unchanged.