FACULTY/STAFF GIVING FORM
Giving Societies
Council Oak Leadership Society 1924 Loyalty Society
Member: Annual gift $1,000 or more Member: Three or more
($38.47 for 26 pay periods) consecutive annual gifts
Name: ID:
Dept.: Ext. #: _______________________
SIGNATURE: _________________________________________________________________ Date: _________________________
I would like to make a gift through payroll deduction: Complete this form electronically and
email it to Shiellee Adams at sadams5@naz.edu (see reverse side for frequently asked questions about payroll deduction)
Option 1: I would like to make an ongoing OPEN-ENDED pledge.
I authorize Nazareth to deduct $_____________ per pay period (min. $5).
Option 2: I would like to make a ONE-YEAR pledge of : $_______________
I authorize Nazareth to deduct $_____________ per pay period
(x 26 pay periods- min.$5)
Option 3: I would like to make a ONE-TIME gift of $ ________________ to Nazareth College.
To make a gift by check: Mail this completed form to:
Nazareth College Office of Development • 4245 East Avenue • Rochester, NY 14618
To make a gift by credit card: Visit our secure giving page at giving.naz.edu to make a one-time gift or to set up a recurring
gift schedule.
Please designate my gift to:
The Nazareth Fund – The College’s highest priorities
Student Financial Aid – Keeps a Nazareth education accessible and affordable
Diversity and Inclusive Excellence – Supports diversity, equity, and inclusion initiatives across campus
Student Life – Supports the undergraduate experience
President’s Fund for Emerging Needs – Provides the president with access to
resources to support new initiatives and promote our mission
SPARK Grants — Supports experiential learning opportunities for undergraduate
students such as research, study abroad, and internships
Global Engagement – Enable international learning & research experiences to enrich
students’ lives with global and cultural awareness
Other: __________________________________________________________
(you may split your gift, if you choose)
My spouse works for a matching gift company (Please send in the necessary forms to ensure a match)
_________________________________________________________
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