On-Line Giving
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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 *
Zip/Postal Code *
Daytime Telephone *
Email *
What prompted you to make this gift?  
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$) *
Credit Card Type *
Credit Card Number *   Verification Code *
Expiration Date *   *
Name on Card *
Directed Donations
* I would like this gift to be directed to:

$ Dutchess Day Fund
$ Yearbook Advertisements
$ (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 Eileen Shaw at 845-677-6722 or mail to Eileen Shaw, Interim Director of Development, Dutchess Day School, 415 Route 343, Millbrook, NY 12545.

In Honor / Memory of
I would like this gift to be in Honor / Memory of:
      In Honor   In Memory
  Please send an acknowledgment of my gift to:
Special Instructions
Any special instructions we should know?

Thank You! Your receipt will be mailed to the above address.
Copyright © 2023, Dutchess Day School and Net Directories Inc.

DDS | 415 Route 343 | Millbrook, NY 12545 | Tel: 845-677-5014 | Fax: 845-677-6722