Senior Class 2016 Legacy Campaign
Student Donation Form
Credited to the 2015-2016 Annual Fund
Please Print Clearly
Name: ________________________________________________________________
Address: ______________________________________________________________
City:___________________________ State:______________ Zip Code:___________
E-Mail Address:________________________ Daytime Phone:
--------------------------------------------------------------------------------------------------------------------------------________I am making a contribution for the Senior Class gift in the Amount of $_________________
(Requested Donation $22.00)
A portion of this contribution will go to the Senior Legacy Scholarship started by the Class of 2016
Payment Options:
Cash ____
Check ____ (make checks payable to HOLY FAMILY UNIVERSITY)
Please charge my credit card: (circle one)
VISA
MC
DISCOVER
AMERICAN EXPRESS
Name on Credit Card if Different from Above
Credit Card #
Expiration Date:
Three-Digit Security Code:
Signature:
Please return completed form with your contribution Or
Make your gift online at www.holyfamily.edu and click “Giving” on the right side of the page.
Shirt Size Ordered: ____Small ____ Medium ____ Large ____ XLarge
Other _________________
Please return completed form and donation to Cindy Brong in CC-212
FOR OFFICE USE ONLY:
Donation Received By: ___________________________________ Date: ______________________
Shirt Delivered:
Size: ____Small ____Medium ____Large ____ XLarge
Other _________________