DELTA COLLEGE FOUNDATION
DONATION/PLEDGE FORM
Date:
Name:
Address:
City:
State:
Zip Code:
Phone:
I wish to make a donation of:
$
Frequency:
Monthly
Annually
One Time
Payment method (select one):
1.
Check Enclosed
2.
Charge my Credit card:
MASTERCARD
VISA
DISCOVER
AMEX
Name on Card:
Card Number:
Expiration Date:
Security Code:
Signature:
Gift Use:
Field Trips
Associated Student Body
Passport to College
Unrestricted Donation
Unspecified Scholarship
SJDC Program Council (please specify):
SJDC Scholarship (please specify):
Print and mail this completed form (along with check if applicable) to:
Delta College Foundation
Attn: President's Office
5151 Pacific Ave
Stockton, CA 95207
Questions? Contact the President's Office at 209-954-5018
Print Form