University Of Wisconsin Foundation Gift Form

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GIFT FORM
To make a gift, please make your check payable to the University of Wisconsin Foundation
and mail it with this completed form to: University of Wisconsin Foundation, US Bank
Lockbox, Box 78807 , Milwaukee WI 53278-0807 . If you want to use a credit card, fi ll
out the information below, sign and mail to the address above.
I/we want to support ongoing programs for educational excellence at the University of
Wisconsin-Madison with my/our gift of $ __________________________________________
A matching gift program can double or even triple your gift. If you want to have your gift
matched by your employer, please check one of the following boxes:
 Printed form enclosed  I will initiate this match on my company’s Web site
Company’s name _______________________________________________________________
I/we want to designate my/our gift to ______________________________________________
______________________________________________
Name _________________________________________________________________________
Address _______________________________________________________________________
City _____________________________________________ State ________ Zip ____________
Phone:  Home (Landline)  Work  Cell _____________________________________
Email _________________________________________________________________________
Job Title _______________________________________________________________________
Company Name ________________________________________________________________
Company Address ______________________________________________________________
City _____________________________________________ State ________ Zip ____________
 Check here if this is a new address
Credit Card Information
Please charge $ _______________________ to my credit card.
 MasterCard  Visa  American Express  Discover
Card Number _________________________________________ Expiration Date ___________
Cardholder name (please print) ___________________________________________________
Cardholder signature ____________________________________________________________
Thank you for your support. Please call on us whenever you have a question or need
information about making a gift.
UNIVERSITY OF WISCONSIN
FOUNDATION
1848 University Avenue • Madison WI 53726-4090 • • 608-263-4545

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