www.smu.ca/administration/development/gift.html
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Receipt will be issued for all eligible donations. Charitable Business # BN 11918 9900 RR0001
DDOONNOORR IINNFFOORRMMAATTIIOONN
❒ Ms ❒ Mr ❒ Mrs ❒ Dr ❒ Other
First Name ________________________Initial _________Last Name _____________________________________________
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ddress___________________________________________________________________________
City ________________________ Province / State ________________________Country_____________________________
Postal / Zip Code ________________________
To keep informed on University news and events, please indicate your preferred email address:
Preferred Email Address ___________________________________________
❒ Home ❒ Business
Preferred Telephone No ___________________________________________
❒ Home ❒ Business
Please indicate whether you are:
❒ Alumni ❒ Student ❒ Faculty ❒ Staff ❒ Other
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❒ I wish to make a one time gift of $ ___________________
❒ I wish to make a total pledge of $ ___________________
My installments will be made ❒ Monthly ❒ Bi-monthly ❒ Quarterly ❒ Annually
M
y first installment of $_________________will be made on ( month / year )___________________and will be payable
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ver _________years. ( Monthly donations will be processed on the 1st day of each month. All scheduled donations will
continue until we are notified to discontinue.)
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❒ I have enclosed a cheque payable to Saint Mary’s University.
❒ I authorize Saint Mary’s University to make automatic withdrawals from my:
❍ Credit Card ----- ❍ Visa ❍ Mastercard ❍ American Express ----
Card Number # : _________________________________________ Expiry Date : ___________________
_________________________________________
( Cardholder Signature )
WWHHEERREE TTOO GGIIVVEE
❒ Annual Fund ( area of greatest need ) ❒ Faculty / School / Department of: _____________________
❒ The Homburg Centre for Health & Wellness ❒ Student Financial Aid
❒ Athletics ❒ Your preference ____________________________________
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❒ My company will match my gift, and a completed matching gift form is enclosed.
❒ Please
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publish my name in the annual donors’ report.
❒ Please send information on planned giving ( bequests, life insurance ).
Your donations ARE MAKING A DIFFERENCE
•
scholarships & bursaries
•
new & renewed spaces
•
exciting research
• athletics
DONATION FORM
