The Center for Public Service
Barbara E. Moely Service Learning Teaching Award
Thank you for supporting the Barbara E. Moely Service Learning Teaching Award!
Please list my/our name(s) as follows:
Address
City/State/Zip
Phone
E-mail Address
Amount of my gift/pledge: $
At this time I am enclosing the full amount of my gift.
At this time I am enclosing $
, please send reminders for the balance to me
quarterly/monthly/yearly/
(circle one).
Included is a matching gift form for my/my spouse’s employer.
Payment Method
Check (Make payable to the Administrators of the Tulane Educational Fund and reference the
Barbara E. Moely Service Learning Teaching Award in the memo)
Credit Card (See below)
Online at https://tulaneuniversity.ejoinme.org/?tabid=311859 (Allocate to Other and reference
“Barbara E. Moely Service Learning Teaching Award” in special instructions section)
For other giving options, please contact Jackie Mabry
504.862.3398 office or 504.214.8025 cell
jmabry@tulane.edu
Credit Card

Visa

MasterCard

AmEx

Name (as appears on card)
Amount Charged
Expiration Date
Card #
Card Security Code (CSC)*
*For added security, we require the 3-digit code from back of card (American Express, the 4-digit code from front)
Please return this form with your donation to Tulane University P.O. Box 61075 New Orleans, LA 70161
FOPS1