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Print and Mail Gift Form GiftsPlus Matching Gifts Search Engine
Mail to: Office of Development Box 1893 Providence, RI 02912 Phone: 800.662.2266 Fax: 401.863.3301 |
Date: ___/___/_______ |
98887 |
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| Section I: Donor Information |
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Name: |
____________________________ | Class/Parent year: ________ |
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Spouse: |
____________________________ | Class/Parent year: ________ |
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Address: |
____________________________ | Daytime Phone: _______________ |
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| ____________________________ | Evening Phone: _______________ |
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| ____________________________ |
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| Section II: Gift Allocation |
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| Annual Support |
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Brown Annual Fund |
$ ________________ |
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Brown Medical School Annual Fund |
$ ________________ |
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Brown Sports Foundation (All-Sports Fund) |
$ ________________ |
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Other Sports ________________________ |
$ ________________ |
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Brown Alumni Magazine |
$ ________________ |
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Other ________________________ |
$ ________________ |
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TOTAL |
$ ________________ |
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| Capital Gifts |
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New Endowment (have a representative call me) |
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Add to Existing Endowment _____________ |
$ ________________ |
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Facilities/Other _______________________ |
$ ________________ |
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| Section III: Gift Opportunities |
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I would like to speak with a representative from the Office of Development regarding: |
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| Bequests |
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| Gifts of Appreciated Assets |
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| Charitable Trusts or Annuities |
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| Named Endowment Funds |
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| Named Gift Opportunities |
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| Gifts of Tangible Personal Property |
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| Is Brown in your will or other testamentary plans? |
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| Yes No Would consider |
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| Section IV: Gift Instructions |
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This gift is: |
In honor of On behalf of In memory of |
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Name: |
___________________________ |
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| Section V: Credit Card Information |
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| Name:____________________________________ | (As it appears on card.) |
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Type: |
American Express Brown MasterCard Brown VISA MasterCard VISA |
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| ___________________________________ | __________________ |
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CARD NUMBER |
EXPIRATION DATE |
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| ___________________________________ |
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SIGNATURE |
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Mail to: |
Brown University Gift Cashier Box 1877 Providence, RI 02912 |
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