_________________________________________________________________________________________________
Prefix First Middle Last Suffix
_________________________________________________________________________________________________
Street Address City State Zip
_________________________________________________________________________________________________
Preferred Phone (Home, Mobile, Work) Preferred Email Address
_________________________________________________________________________________________________
Spouse Full Name (Prefix, First, Middle, Last, Suffix) Spouse’s Class Year (if an A&T alumnus/a)
(please indicate month)
Please draft my gift: For ______________ month(s) –OR– Until written notification.
Stock/Securities Transfer Please call 336-334-7600.
I have included A&T in my estate plans or I would like information on how to do so.
Matching Gift My employer’s matching gift form is enclosed or will be sent.
Signature ______________________________________________________ Date ______________________
A signature is required for all debit, credit card, and bank draft gifts.
Advancement Operations • Dowdy Building, 4
th
Floor, Suite 400 • 1601 E. Market Street • Greensboro, NC 27411 • (336) 334-7600
EVERY AGGIE
. EVERY YEAR.
Thank you for supporting North Carolina A&T State University.
19GEN
Please complete this form in its entirety and return it to the Office of Advancement Operations.
Give online at www.ncat.edu and click Give to A&T. Give over the phone by calling
888-248-2821 or locally at 336-334-7600.
I am an A&T alumnus/a. Class Year: ____________ Major: _________________________ Degree: ____________
Chapter Affiliation_________________________________________________________________________
This is a joint gift with my spouse. Check here if you wish to make your gift anonymous.
This gift is in honor/memory of ___________________________________________________________.
MY/OUR TOTAL GIFT TO A&T IS $ ____________________________.
GIFT PAYMENT OPTIONS
Cash/Check (Checks made payable to: North Carolina A&T Foundation, Inc.)
Debit/Credit Card Visa
MasterCard
American Express
Card Number: ___________________________ Expiration Date: ___________ Security Code: ______
Bank Draft (Please attach a voided check that contains your bank information)
Pledge (Please fulfill your pledge by June 30 to receive credit for the current fiscal year)
My debit, credit card, or bank draft gift is a:
Lump sum one-time contribution of $ _______________.
Monthly contribution of $_________________ to be drafted on the 1st 5th 15th 30th
beginning in ______________________________.
click to sign
signature
click to edit
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