Yes, I want to support current and future students at the Western College of Veterinary Medicine
through a class gift!
To support the WCVM Class of 2006 Externship Fund, I’d like to make:
A one-time gift of
$ 150.00
$ 2006.00
$Other Amount_________
Or an ongoing pledge of $_________ over _________years:
Paid Monthly
Paid Annually
To I’d like to give by:
Cheque or money order
Visa
MasterCard
American Express
Post-dated cheques (for monthly gifts only)
Pre-Authorized Debit (see below)
Or Give online now at www.usask.ca/makeagift or phone 1-800-699-1907 (online: please be sure to enter in that your gift is designated to the Western
College of Veterinary medicine and put ‘WCVM Class of 2006’ in the comments. Over the phone please mention your gift is for the WCVM Class of 2006)
Credit Card Payment: __ __ __ __/ __ __ __ __/__ __ __ __/__ __ __ __/ Expiry Date_______/_______(month/year)
Name as shown on card: _______________________________ Signature: ______________________________ Date: ________________
Is this a corporate credit card? Yes ___ No ___ If yes, name of the company ________________________________
Pre-Authorized Debit Option: If you wish to donate through automatic withdrawals from your bank account, please complete and return a
Pre-Authorized Debit (PAD) Agreement found on our website at www.usask.ca/pad or contact our office at 1-800-699-1907 to have the agreement
mailed to you for completion.
Please be sure to mention that this is for the WCVM Class of 2006 fund.
Donor Name: ____________________________
___ Joint Gift with: ________________________
________
Donor Address: ______________________________
__
______________________________
Donor Email: ____________________________
__
___ Donor Phone #: ______________
Do you wish to keep your gift anonymous:
__________________
Please DO NOT publish my name with regard to this gift
Please DO NOT publish my name with regard to all gift
Thank you!
Canada Revenue Agency Charitable Organization Registration
NO. 11927 9313 RR0001