Contribution
Form
Contributions may be made by mail, phone, or
credit card. To
mail in your gift, please print this form and send it to our address at the top
of the form. If you prefer, you may
phone in your credit card information to the
______________________________________________________________________
Donor Information:
Name:
__________________________________________________________________
Address:
________________________________________________________________
City:
Phone
Number: W ( ) _________________;H ( )
___________________________
E-mail
Address: _____________________________________________
(Please
make checks payable to
Enclosed is my gift of: $____________________________
Please apply my gift as
follows:
p Area
of greatest need
p Annual
Fund
p Other (please
designate) _____________________
Please charge my: p VISA p MasterCard:
Card
Number: ________________________________ Expiration Date: ______________
Signature:
_______________________________________________________________
p I
wish to make a multiple-year pledge. Click here for a Pledge Agreement
form.
p Please
contact me about including
For
more information about a multi-year pledge, including
_______________________________________________________________________
This gift is made p In Memory or p In Honor of:
(Specify Name)
__________________________________________________________
Please send acknowledgement
to:
Name:
_________________________________________________________________
Address:
________________________________________________________________
City: