| * Donor Name: |
Put your name here if it is different from the credit card holder. |
| * Relationship with KGI: |
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| * First Name on Credit Card: |
Example: John, as it appears on your credit card. |
| * Last Name on Credit Card: |
Example: Smith, as it appears on your credit card. |
| * Billing Street Address: |
Example: 535 Watson Drive |
| * City: |
Example: Claremont |
| * State: |
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| * Zip Code: |
Example: 91711 |
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Mailing address same as billing address |
| * Mailing Street Address: |
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| * City: |
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| * State: |
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| * Zip Code: |
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| * Credit Card Type: |
Visa MasterCard American Express
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| * Credit Card Number: |
Example: 1234567890123456 |
| * Expiration Month (mm): |
Example: 01 for January |
| * Expiration Year (yyyy): |
Example: 2004 |
| * CVV2/Security Code: |
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| * Amount (US Dollars): |
Examples: 50.00, 1000.00. Do not use commas. |
| * Designation: |
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| * Phone Number: |
Example: 9096070128 |
| * E-mail Address: |
Example: yourname@kgi.edu |
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Please click on the "Process" button below to submit your gift.
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If you are interested in discussing a major gift or planned gift to KGI,
please contact Kerry Howell, Vice President for Advancement.
If you have other questions or would prefer to make your credit card gift over the phone, please call (909) 607-0128 or
e-mail us at pioneerfund@kgi.edu. Do not e-mail us your credit card information!
To send a check (made payable to Keck Graduate Institute) or credit card gift through the mail, you may print this form, complete it, and mail to:
Office of Advancement
Keck Graduate Institute
535 Watson Drive
Claremont, CA 91711-4817
If your employer will match your gift, please send a completed matching gift form to the above address.
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