Fillable Uni Of California Santa Cruz Gift Form printable pdf download

Gift Form

for gifts / pledges up to $25,000. For gifts / pledges

over $25,000, please contact giving@ucsc.edu

In consideration of my interest in supporting the mission of UC Santa Cruz, I wish to make

an irrevocable gift to the UC Santa Cruz Foundation for the purpose(s) described below:

$ ______________ The UCSC Fund, unrestricted, to be used for priority projects determined by the Chancellor.

$ ______________ Restricted for the following purpose(s): _________________________________________________

________________________________________________________________________________________________________

Outright gift of $______________ (Payment enclosed) (or)

Pledge of $ _______________________to be paid over ____________ months in equal installments

(Pledges are to be fulﬁlled within one year). The ﬁrst payment of $ _____________ is enclosed.

Bill my credit card: ❏ VISA ❏ MasterCard ❏ American Express ❏ Discover

09/2018

Number _____________________________________________________________ Expiration _______________________

Signature _____________________________________________________________________________________________

❏ Monthly installments of ___________________________ ($25 is the minimum amount for credit card charges).

Donor Name(s) ________________________________________________________________________________________

For recognition purposes, please list my name as _______________________________________________________

❏ I do not want my name in any donor listing.

please print

Contact giving.ucsc.edu to make a gift in honor or memory of someone special.

Address _______________________________________________________________________________________________

State

City __________________________________________________ State _____________ Zip Code _____________________

Telephone: Home (

) ______________________________ Business (

) _________________________________

E-mail: Home _________________________________________ Business ________________________________________

❏ In addition, my employer (company name) _________________________________________ will match my gift.

The ﬁrm’s matching-gift form ❏ is enclosed ❏ will be mailed.

Please return form to:

UC Santa Cruz Foundation, Dept. 44787, PO Box 44000, San Francisco, CA 94144-4787

For more information on matching gifts, go to:

As is customary with other University of California campuses, UC Santa Cruz uses a small portion of every gift to keep accurate

records and be more accountable to you. We strive to keep your return on investment high; 94% of your gift goes directly to the

program you designate. Your gift is tax-deductible to the full extent of the law. If you have speciﬁc tax questions, we advise you

to consult your personal ﬁnancial or legal adviser. The UC Santa Cruz Foundation Tax ID number is 23-7394590. Contact the

Director of Annual Giving, Marketing and Memberships with questions at 831-459-2489 or pragias@ucsc.edu. (Form version 9/18/12)

Uni Of California Santa Cruz Gift Form