On-Line Donations

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Donor Information

= required

Full Name *

Affiliation *

Class Year

(4 digits, if applicable)

Address Line 1 *

Address Line 2

City *

State/Province *

Postal/Zip Code *

Country

Daytime Telephone *

E-Mail *

Recognition

Please indicate how you would like your name(s) to be recognized in our Donor Listings.

I wish for my name to remain anonymous

Payment Information

I would like to make a gift of:

Total Gift Amount (US$) *

Please charge me *

Annually
Quarterly
Monthly	with payment/installments of (Amount US$)
One-time Gift

Please keep my credit card details on file for any installment payments

Payment Type *

Matching Gifts?

Please indicate whether your employer or your spouse's employer will match your gift.

	Yours \|	Spouse \|	Organization Name(s)
Yes, matching form will be sent later
No, matching not available

Please email your form to the Advancement office to wendtha@albanyacademies.org or mail to The Albany Academies, 135 Academy Road, Albany, NY 12208

In Honor/Memory of

This gift is in honor or memory of someone special:

Name(s)

In Honor In Memory

Please mail a letter on my behalf to the following person:

Full Name

Full Address (incl. City/State/Zip)

Special Instructions

Any special instructions we should know?

Thank You! Your receipt will be mailed to the above address.