ULM Alumni Association Gift Form

Make your gift to the ULM Alumni Association today!

Your gift to the ULM Alumni Association automatically makes you an active member! There are two easy ways to complete this gift form:

1. PRINT this form, complete by hand and mail it to the above address below, along with your check or money order. For online payments, click here.
2. FILL OUT this form within your Web browser, print it, and mail it to the address below, along with your check or money order. For online payments, click here.

Thank You! The ULM Alumni Association appreciates your generous support of ULM!

Yes! I want to make a gift to the ULM Alumni Association! Here's my alumni information:

YOUR NAME AT GRADUATION
First:			Middle or Maiden:			Last:

	Undergraduate	Masters	Doctorate
Class Year:
Major:

Birthdate: (month/dd/yyyy)

Month:

Day:

Year:

Social Security Number:

Address:
City:			State:			Zip:

Home Phone:

(

)

E-mail:

SPOUSE'S NAME AT GRADUATION (if NLSC/NLU/ULM Alum)
First:			Middle or Maiden:			Last:

	Undergraduate	Masters	Doctorate
Class Year:
Major:

Birthdate: (month/dd/yyyy)

Month:

Day:

Year:

Social Security Number:

Address:
City:			State:			Zip:

Home Phone:

(

)

E-mail:

EMPLOYMENT INFO
Employer:			Occupation:

Address:
City:			State:			Zip:

Work Phone:

(

)

ext.

E-mail:

Fax:

(

)

GIFT LEVELS
Individual: $25	Couples: $35	Legacy Society: $500
PAYMENT METHOD (please make payable to: ULM Alumni Association)

Check/Money Order

Bank Draft (please include voided check)

Signature

Mail this Gift Form to:
ULM Alumni Association
Anna Gray Noe Alumni Center
Monroe, LA 71209-9010