Donor Information

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Last Name*
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Class year/yrs attended

(For Employer matched gifts, send matching gift form to Urbana Institutional Advancement Office, 579 College Way, Urbana, OH 43078)

Annual Fund Contribution

Gifts to the University are tax deductible as allowed by law.

You may make multiple designations in one gift and all amounts will be totaled below.

I/we prefer that my/our gift to the Urbana University for one or more of the following:

Give Towards

Other: $
All amounts will be totaled here. Total $

If you have special instructions, designations or if this gift is in memory or in honor of someone, please indicate it in the text box below.

Thank you for your support!