800 College Avenue, Weed, CA 96094 ~ (530) 938-5373 ~ Fax (530) 938.5570 ~ foundation@siskiyous.edu
Cash Donation Form
YES, I want to make a gift to College of the Siskiyous Foundation
Enclosed is my check for: $10,000 $5,000 $1,000 $500 $250 $100 Other $
Diamond Club Emerald Club Ruby Club Oak Club Cedar Club Manzanita Club
Charge my donation to my: Visa Discover MasterCard
Account #
Exp. Date: CVR#
Signature:
Date:
Donor’s Name (please print):
Home Phone:
Address: Work Phone:
City: State:
Zip: Cell Phone:
E-mail:
I am giving my gift as a memorial/tribute and I have filled out the memorial/tribute below.
This gift is a: Memorial Tribute In honor of:
We will send an acknowledgment of your gift to:
Name:
Address:
City: State: Zip:
Please designate my gift for the following purposes:
Where need is greatest (unrestricted--Friends of COS Foundation)
Scholarships for students General Named:
Instructional equipment
Other:
I/we have named COS in a will, trust or insurance arrangement
Count me as a COS alumnus! I have attended classes at COS I earned a degree or certificate from COS Year:
Please send me more information about
Providing for COS in my will or trust. Providing for increased income in my retirement years.
Establishing an endowment fund. Making a gift of appreciated stock.
Membership in the Legacy Society. Membership in the Friends of College of the Siskiyous.
Please make checks payable to COS Foundation (tax deductible) and return this completed form to:
COS Foundation, 800 College Avenue, Weed, CA 96094
Office: (530) 938-5373 ~ Fax: (530) 938-5570 ~ Email: foundation@siskiyous.edu ~ Tax ID #94-3146801
Important Information About Your Donation
You must file form 8283 if the amount of your deduction for all non-cash gifts is more than $500. Please see the Foundation Office for non-cash gifts valued over
$5,000.
If the College of the Siskiyous Foundation disposes of your non-cash gifts over $5,000 within two years of receipt, the College of the Siskiyous Foundation must
complete IRS Form 8282 and send a copy to the IRS and you.