Gift & Pledge Form

I/we are proud to support the College of Public Programs through a gift of $________.

My/our gift is designated toward (name unit or state if it is an unrestricted gift):
____________________________________________________________________

Type of Gift:

_____ Student Support
_____ Faculty Support
_____ Program Support

My/our gift is:

_____ A one-time gift
_____ An annual gift
_____ An endowment
_____ A planned gift

My/our pledge will be fulfilled as follows:

_____ My/our total gift of $_____ is enclosed.
_____ My/our gift of $_____ is in the form of a pledge.
           Please contact us to arrange pledge payments
           (pledges may be paid over a period of one-to-five years)

College of Public Programs affiliation:

_____ Alumnus/a _____ Friend _____ Parent
_____ Faculty/staff _____ Student _____ Other

If you are an alumnus/a, please tell us:

Degree year(s):_____ School/Unit: __________________________________________________________

Please provide us with your information:

Name(s)________________________________________________________________________________

Preferred Mailing Address___________________________________________________________________

City/State/Zip____________________________________________________________________________

Home Phone:_______________________________ Daytime Phone:_________________________________

Preferred email address:____________________________________________________________________

Additional Information: _____________________________________________________________________

_______________________________________________________________________________________

Payment Method:

_____ Cash (checks payable to the ASU Foundation)*

_____ Credit Card       Card type:_____________________________________________________________

Card #:____________________________________________________________________________

Exact name on card: _________________________________________________________________

Expiration month/year:________________

Signature:__________________________________________________________________________

Return this form to:

College of Public Programs
Arizona State University
PO Box 870803
Tempe AZ 85287-0803

Questions? Call (480) 965-1034

*Funds will be deposited with the ASU Foundation, a separate nonprofit organization that exists to support Arizona State University.