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 *
Province/State *
Postal/Zip Code *
Daytime Telephone *
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 (CDN$) *
Please debit my credit card *
Monthly         with payment/installments of   (Amount CDN$)
One-time Gift  
Please keep my credit card details on file for any installment payments
Credit Card Type *
Credit Card Number *   Verification Code *
Expiration Date *   *
Name on Card *
Directed Donations
* I would like this gift to be directed to:
$ Annual Fund
$ re:forming Tomorrow Campaign
$ Academic Programs
$ Caven Library
$ Student Bursaries
$ Building Restoration
$ Ewart Centre for Lay Education
$ Asian Centre
$ 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  
In Honour / Memory of
I would like this gift to be in Honour / Memory of:
      In Honour   In Memory
  Please send an acknowledgement of my gift to:

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