2023 Take Back the Night Donation Pledge
October is Domestic Violence Awareness Month, and we are getting ready for our 34th annual Take Back the Night (TBTN) March and Rally to end power-based interpersonal violence on October 26th, 2023. One of the ways in which you or your organization can be of assistance is by making a financial contribution or a gift-in-kind that will help purchase carrying candles and cups, light sticks, and cover the costs of publicity, program booklets, sound services, transportation, safety information, and other related costs to the event. All donors will have their name recognized in the program and donating organizations over $100 will receive a shirt for all members of their org. In addition to this, your members could volunteer to help with event logistics such as set-up, take-down, moving items, distributing materials, and so on. These are equally important and appreciated.

Sign in to Google to save your progress. Learn more
Contact name *
Contact E-mail *
How are you connected to WIU?  
Clear selection
Donation/pledge amount
How would you like to donate
Clear selection
Date by which you can make the payment
MM
/
DD
/
YYYY
Personal/Organization name to be posted on program (on the day) *
Your contribution is greatly appreciated.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Western Illinois University. Report Abuse