On-Line Donations
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Donor Information
* = required
Full Name *
Affiliation *
Year of Graduation     (4 digits, if applicable)
Address Line 1 *
Address Line 2  
City *
State/Province *
Postal/Zip Code *
Email *
Please indicate how you would like your name(s) to be recognized in our Donor Listings.
I wish for my name to remain anonymous
Credit Card Information
I would like to contribute:
Total Donation Amount (US$) *
Please debit my credit card *
Monthly         with payment/installments of   (Amount US$)
One-time Gift  
Perpetual Payments?   I wish to pay the installment amount on a recurring basis until further notice
Your credit card details will be kept securely on file only if needed for installment payments
Credit Card Type *
Credit Card Number *
Expiration Date *   *
Name on Card *
Directed Donations
* I would like this gift to be directed to:
Unrestricted Funds
Capital Campaign
Sports Equipment
Theatre Productions
Class of '62 Memorial
Music Program
Library Acquisitions
Endowment Fund
Other (Please Specify)
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 fax your form to Humphrey LaBlanc at 416-483-8492 or mail to him in care of the Annual Fund Office, Gregorian College, #1 Pondside Drive, The Grange, England OR2476.

Special Instructions
Any special instructions we should know?

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

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