Nampa Shares and Cares Pledge

2. 

4. NAMPA SHARES AND CARES PLEDGE

6. Tax-deductible donations will be used exclusively to help less fortunate Nampa residents with their city utility bill. More information can be found on the utility webpage, http://www.cityofnampa.us/index.aspx?nid=140

   Tax-deductible donations will be used exclusively to help less fortunate Nampa residents with their city utility bill. More information can be found on the utility webpage, http://www.cityofnampa.us/index.aspx?nid=140

8. Please add the amount indicated to my bi-monthly bill.

   Please add the amount indicated to my bi-monthly bill.

10. Donation Amount

    1. $1

    1. $2

    1. $5

    1. Other

11. Enter Other Amount

13. Acknowledgement
    I understand this amount will be added to each of my bills until I call the office and cancel this bi-monthly donation. This additional charge will start on my next billing. I acknowledge that by typing my first and last name below it will be considered my signature, which authorizes this additional charge to be added to my utility bill.

    I understand this amount will be added to each of my bills until I call the office and cancel this bi-monthly donation. This additional charge will start on my next billing. I acknowledge that by typing my first and last name below it will be considered my signature, which authorizes this additional charge to be added to my utility bill.

15. 1. Check here to agree

17. Name

    Name

20. Service Address

    Service Address

23. Account Number

    Account Number

26. Phone Number

    Phone Number

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field