Class Giving Reply Form From: Alumnus/a: ______________________________________ Class Year: __________________ Address: ___________________________________________________ Home  Business City: ____________________________________ State: _________Zip: __________________ Phone: ______________________________Email: ___________________________________  Home  Business  Cell  Home  Business  Yes! I wish to support WCMC medical students with a gift to my Class Fund in the amount of $_______________.  Enclosed please find a check made out to Weill Cornell Medical College. Cornell University’s tax identification number is: 15‐0532082.  Please charge my credit card:  Mastercard  Visa  American Express _________________________________ __________________ Card Number Expiration Date _________________________________________________________ Name of Cardholder _________________________________________________________ Cardholder Signature  I would like information on joining the Dean’s Circle.  I would like information about transferring securities.  I would like information on making a gift to Weill Cornell through my will or trust. Please fax this form to 212.832.0205 or mail with your check to: Office of Development Weill Cornell Medical College 1300 York Avenue, Box 123 New York, NY 10065 If you have any questions about making a gift, please contact the Office of Alumni Relations at 646.317.7419 or alumni@med.cornell.edu.