For VPIA use
only
Account
Name
Monthly Amount
Gift Designation:
If no account designation is made, funds will be applied to the area of greatest need.
Authorization for Payroll Deduction (Complete this only if paying through payroll deduction):
I voluntarily authorize the monthly deduction from my after-tax wages for a charitable contribution as indicated above. I understand that I may
revoke this authorization at anytime by providing written notice to the Ofce of Institutional Advancement.
Signature Date
One-time gift Amount $ Check # Cash
You may pay with cash, check or money order. If paying with a check or money order, please make it payable to
Texas
A&M International University.
You may also make a one-time or recurring gift at go.tamiu.edu/give
Privacy Notice: State Law requires that you be informed of the following: (1) you are entitled to be informed about your information
collected in this form as provided by law; (2) you are entitled to receive and review that information; (3) you are entitled to have the
information corrected at no charge to you.
May 24 2017
Yes! I’d be happy to be a Sustaining Partner. My recurring and indenite donation will
build and strengthen TAMIU by helping students begin their journey here (minimum $5
monthly contribution).
12 Months
Ongoing option for 12-month employees -
Indenitely and deducted on a monthly basis.
9 Months
Ongoing option for 9-month employees -
Indenitely and deducted on an academic-year
basis (9 month basis for September through May only).
Check one:
New/Renewal Membership
Cancellation
Update
Check one:
Faculty
Staff
Administrator
Employee Name
Employee Information - Please print or type.
Universal Identication Number
Department Name Email
Annual Giving Campaign
Employee Contribution Authorization Form
For HR Ofce Use Only
Date Posted
Effective (Pay Date) Initials
Share my name on Donor List
My gift is anonymous
click to sign
signature
click to edit
Scholarship Fund Accounts
Faculty & Staff STEM Scholarship Endowment
Area of Greatest Need
A. R. Sanchez, Jr. School of Business Scholarship
Art General Scholarship
Athletics General Scholarship
Bilingual Graduate Scholarship
Blanche Flores Leyendecker Scholarship
Chamber/Orchestra General Scholarship College
of Arts and Sciences General Scholarship College
of Education General Scholarship
Dance General Scholarship
Dee Michelle Memorial Scholarship for Psychology
Dr. F. M. Canseco School of Nursing Scholarship
Fifth Year Senior Athletic Scholarship
Fine and Performing Arts Scholarship
Gear Up Scholarship
Graduate School General Scholarship Fund
Guitar Ensemble Scholarship
Honor/Memorial Scholarship
Honors Scholarship Fund
International Student Emergency Scholarship
Jack R. Brown Golf Scholarship
Joe García STEM Scholarship Fund
Josette and José Palacios STEM Scholarship
Killam Library Scholarship
Lacey Cigarroa Keck Endowed Scholarship
Music General Scholarship
TAMIU Alumni Association Scholarship Fund
TAMIU Book Scholarship Fund
For a complete list of all programs and scholarships, please contact the Ofce for Institutional Advancement or visit www.tamiu.edu/vpia