Yes! I want to support Purdue University Calumet! Please fill out the gift form below.
Name: ______________________________________________
Spouse/Partner Name: _________________________________
Address (City, State, Zip) __________________________________________________________
Phone: _______________________
Please recognize me/us as (Mr. (and Mrs.) Robert Smith, Robert (and Margaret) Smith, Bob (and
Peggy) Smith)
______________________________________________________________________________
_____I am an alumnus/a. I graduated in ______ with a degree in_________________________.
Please designate my gift as indicated below:
____ Annual Fund
____ Chancellor’s Strategic Development Fund
____ General Scholarship Fund
____ Alumni Scholarship Fund
____ Other _____________________________________
I WOULD LIKE TO MAKE A PLEDGE:
I intend to make a gift of $___________ to be paid over the next __ year/s.
I will begin payments in _____________ (month/year). Please send a pledge reminder _______.
Enclosed is my first payment of $________________.
Signature __________________________________ Date: ___________________
I WOULD LIKE TO MAKE A GIFT:
___My check is enclosed. (Please make checks payable to Purdue University Calumet)
I authorize $_____________ to be charged to my ___ VISA ___ MasterCard ___ Discover
Account Number_____________________________ Exp. Date ____________ (Mo/Yr).
Name as it appears on the Credit Card (please print):
_________________________________________________________________________
Authorized signature:
_________________________________________________________________________
Find out if your employer matches! Visit www.matchinggifts.com/purdue today to learn more.