Date: _____________________
Donor Information:
Name: ______________________________________________ Class Year: _____________________
Spouse Name: _______________________________________ Class Year: _____________________
Address: _________________________________________________________________________________________
City: __________________ State: ________________ Zip: ________________
Home Phone: _________________________ Work Phone: _______________________
Cell Phone: _______________________ Email Address: ________________________________________
Gift Information:
Total Gift Amount: $______________________________
Gift Designation:
Academic Excellence Campus Life Student Scholarships Greatest Need
Endowment: _____________________________________________________________________________________
Capital Projects: __________________________________________________________________________________
Other: __________________________________________________________________________________________
Fulfillment Options:
I would like to fulfill this pledge: Monthly Quarterly Semi-annually Annually Starting: __________
Please send me pledge reminders.
Optional Gift Instructions:
This gift is: In Honor of: In Memory of: _____________________________________________________
Matching Gift Information: You can double or triple your gift through matching gift programs!
My employer participates in gift matching.
You can find out if your employer matches at:
My employer is: ____________________________________________________________________________________
My spouse’s employer is: _____________________________________________________________________________
Gift Opportunities:
I would like to speak with a representative from the Office of Advancement regarding:
Bequests Gifts of Appreciated Assets Charitable Trusts or Annuities
Named Endowed Funds Named Gift Opportunities Gifts of Tangible Personal Property
Is Pacific Lutheran University in your will or other testamentary plans? Yes No Would Consider
Fulfillment Information:
Please charge my credit card
Name as it appears on the card: _____________________________________________________________
Type: MasterCard Visa American Express Discover
Card Number: __________________________________________ Expiration Date: _________________
Signature: ________________________________________________________________________________________
My check is enclosed, payable to: Pacific Lutheran University
Please print and mail this form to:
Office of Advancement
Pacific Lutheran University
Tacoma, Washington 98447-0018
Pacific Lutheran University
Division of University Relations
Tacoma, Washington 98447-0018
Phone: 253-535-7177 Toll Free: 1-800-826-0035 Fax: 253-535-8377
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