Plymouth Universty Annual Fund Gift Form
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1Annual Fund Gift Form
Name(s): _________________________________________________________ Class year(s): ____________
Street address: ____________________________________________________________________________
City: _______________________________________ State: ___________________________ Zip: ________
Home phone: (_____)_______________ Cell: (_____)_______________ Business: (_____)_______________
E-mail: _________________________________________________ E-mail type:
Business
Personal
YES! I’m/We’re proud to invest in student potential at Plymouth State.
Enclosed is my gift of:
$2,500
$1,000
$500
$250
$100
$50
Surprise us! __________________
Please direct my/our gift to:
$________
Scholarships (circle one): Undergraduate / Graduate
$________
The Fund for Plymouth State
$________
Academic department: __________________________________________________________
$________
Athletics (circle one): General / Team (please specify): ________________________________
$________
Other: _______________________________________________________________________
GIFT OPTIONS
This gift is in honor of: ________________________________________
Class year: ____________
This gift is in memory of: ______________________________________
Class year: ____________
I/We would like my/our name(s) to remain anonymous.
MATCHING GIFTS
Double or triple the impact of your gift! More than 10,000 employers sponsor matching gift programs that match
charitable contributions made by their employees, employees’ family members, retired employees, and board
members. Visit to see if your gift can be matched.
My employer will match my gift. Employer’s name: _________________________________________
My spouse’s employer will match my gift. Employer’s name: __________________________________
I’m not sure if my employer has a matching gift program. Employer’s name: ______________________
PAYMENT OPTIONS
Check payable to Plymouth State University.
I’d like to learn more about setting up a monthly recurring gift.
Credit card:
MasterCard
Visa
Discover
American Express
Name on card (please print): _______________________________________________________
Signature (required): ______________________________________ Date: __________________
Card number: ____________________________________________ Exp. date: ______________
Thank you for your gift! Please return your completed form and payment to:
Plymouth State University, University Advancement Office, MSC 50, 17 High Street, Plymouth, NH 03264-1595
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Parent category: Letters