EmailMe Form - Secure Giving Form

Gift Designation: *

Gift Amount: *

$ Dollars . Cents

Please enter a gift amount of $5.00 or more.

Give Anonymously?: *

Yes

No

Anonymous donors will not be listed in the President's Annual Report.

Gift Type: *

One-Time Gift

Recurring Gift

Frequency: *

Monthly

Quarterly

Yearly

We will process monthly, quarterly, or yearly sustaining gift until you notify us to stop doing so.

Frequency day: *

Process payment on the 1st day of the month

Process payment on the 15th day of the month

MY INFORMATION

Name: *

Prefix First Last Suffix

Other Name Used:

Prefix First Last Suffix

Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email: *

Phone: *

### - ### - ####

I am a/an: *

Class Year:

If alumnus please enter 4-digit class year, e.g., 1973.

MATCHING GIFT

If matching gift, please check:

If your company participates in a matching gift program, please request and complete the appropriate form from your personnel office.

Company Name:

ADDITIONAL GIFT DESIGNATIONS

Please enter additional gift designation information below. Sample designations (e.g., Memorial Garden, Platinum Sound Machine, Divinity School, etc.)

Designations

1).
2.)
3.)

Additional Gift Designations Information:

ADDITIONAL INFORMATION

Would you like to designate this gift in memory/honor of someone? *

Yes

No

Please select designation option *

In Memory

In Honor

This gift is in honor/memory of:

Please enter text exactly as it should appear.

Would you like to notify the family about this gift? *

Yes

No

Contact Name *

Prefix First Last Suffix

Address to mail gift notification: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please select:

I have included the University in my estate plan.

Please send me information on planned giving.

I would like to receive occasional email updates from the University.

GL Code - Scholarships

GL Code - Student Retention