Please print and fill out this form, then mail it to:
SIUE FOUNDATION
CAMPUS BOX 1082
EDWARDSVILLE IL 62026 Name (Last): __________________________ (MI): ____ (First):_____________________
Spouse (Last): _________________________ (MI): ____ (First):_____________________
Address1: __________________________________________________________________
Address2: __________________________________________________________________
City: _________________________________ State: _________________ Zip: _________
Home Phone: ___________________________ Email: ______________________________
There are numerous funds at the SIUE Foundation for the academic units, academic departments, and academic and University programs as well as various student award and scholarship funds. The following list represents some of the giving opportunities at the SIUE Foundation. To ask about a specific fund, please call Karen or Gayla at 618-650-2345. Gifts may be divided among funds. If you wish to designate your gift to multiple funds, please indicate the amount to go to each fund by the fund’s name.
Please direct my gift as follows: | $ __________ | SIUE Advancement Fund | | (Gifts to the SIUE Advancement Fund may be used at the discretion of the SIUE Foundation’s Board of Directors to help meet campus priorities.) |
| College and Schools | | Examples of University Programs |
|
$ __________ College of Arts & Sciences (03901)
$ __________ School of Business (03001)
$ __________ School of Dental Medicine (03101)
$ __________ School of Education (03201)
$ __________ School of Engineering (03301)
$ __________ School of Nursing (03601)
$ __________ School of Pharmacy (03950)
$ __________ Lovejoy Library (04026)
$ __________ Graduate School (04048)
| |
$ __________ Arts & Issues (04040)
$ __________ Cougar Athletics (04060)
or specify sport ____________________
$ __________ East St. Louis Center (04080)
$ __________ The Gardens (03715)
$ __________ Student Affairs (04081)
$ __________ University Museum (04017)
$ __________ WSIE (04250) |
Examples of Scholarship and Faculty Research Programs
| $ __________ | Great Rivers Chancellors’s Scholarship Endowment (08518)
(This is the general endowment for the Chancellor’s Scholars program.) |
$ __________ Hoppe Faculty Research Endowment (08310)
$ __________ Kimmel Leadership Scholarship Endowment (08687)
$ __________ Dr. Martin Luther King, Jr. Scholarship Endowment (08689)
$ __________ International Student Scholarship Endowment (08280)
| $ __________ | S. Lavernn Wilson Scholarship Endowment (08113)
(This endowment is used to help needy SIUE students cover their children’s daycare costs at the Early Childhood Center.) |
$ __________ Other, please specify: ___________________________________________
Total Contributions: $ _________________
Do you work for a matching gift company? (yes/no) : ______________________________
(if 'yes' please list name of company)
| | My check is enclosed, made payable to the SIUE Foundation |
| |
| | I wish to pay by credit card: ___ VISA ___ MasterCard ___ Discover ___ American Express
Card Number: _______________________________ Expiration Date: ______________
Signature: ______________________________________________________________ |
The SIUE Foundation is a 501(c)(3) organization. Contributions are tax-deductible to the extent allowable by law.
