UCLA Giving

Gift Information

*I would like to make:

a new gift of Other $

Make this an on-going gift

a new pledge to pay in installments over time

Donor Information

Personal

Title:

First name:

Middle name:

Last name:

Suffix:

I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor

Birth date (mm/dd/yyyy):

UCLA graduation year(s):

Spouse/Partner

Name:

UCLA graduation year(s):

Joint Gift

This is a joint gift with
my spouse/partner:

Contact Information

Street:

U.S. Addresses

City, State, Zip:

Non-U.S. Addresses

Non-U.S. City/County
or Province/Postal Code:

Country:

This address is my:

HomeBusiness

Home telephone:

Business telephone:

E-mail address:

This e-mail is my:

HomeBusiness

Gift Options


Matching Gift
	Click here to find out if your company will match your gift.

	My/my spouse's employer will match my gift.
	Company name for matching gifts:
	This company is:	My employerMy spouse's employer

Payment

Payment method:

Credit Card PayPal

Additional Information


	I am the parent of a current UCLA student
	Student name:
	Anticipated graduation year:
	I am interested in learning more about how I can include UCLA in my estate plan.
	This gift is anonymous.

Comments: