Please complete this form and send it with your gift to:
The Office of Annual Giving C/O Mark Rudloff - 27 Old Main - University Park, PA 16802
Date: ______________
If PSU graduate, year of graduation ___________
Name: _______________________________________
If PSU employee: PSU ID ___________________
Address: _____________________________________
City: ________________ State: _____ Zip:_________
Comments: _______________________________
Phone: _______________________________________
_________________________________________
E-mail: ______________________________________
_________________________________________
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I would like to make a gift of:
$ _____________ . ____
Please designate my gift to the following areas:
1.
i.e. College, Campus, or other Penn State Programs

2.
i.e. College, Campus, or other Penn State Programs


The Penn State Future Fund (UXXFF)
Thank you
for making a
difference at
Penn State!
Gift Payment:
 Matching Gifts
 Check enclosed (payable to Penn State)
 Is this a pledge payment Y / N Pledge# _________________
 I will arrange for my employer to match my gift (see to right)
You may be able to double or even triple the
impact of your contribution by taking advantage
of your employer’s matching gift program. Visit
www.matching.psu.edu to see if your employer
participates.
Company Name: ____________________________________
 Electronic Funds Transfers (EFTs)
 Bill my credit card
X ________________________________________________
Signature for credit card authorization
You can choose to have funds transferred directly
from your checking or savings account to
Penn State. An EFT enrollment form is available
at www.eft.psu.edu.
__________________________________________________
Name as it appears on card
 Visa  MasterCard
Exp. Date:
 Discover
 American Express
CVV #:
The Pennsylvania State University
Office of Annual Giving
27 Old Main
University Park, PA 16802
1-888-800-9163
AD300