Donation Form

If you would like to make a contribution, please type your information in the form below, print, and mail it to: Office of Giving Programs Syracuse University 820 Comstock Avenue, Suite 100 Syracuse, NY 13244-5040 (U.S.A.) Please make checks and money orders payable to Syracuse University, with memo: CSTEP. Thank you! Personal Information: First Name: Last Name: Address 1: Address 2: City, State, Zip Code: Country: (If other than US) Daytime phone/fax: Email address: Class year/affiliation: (if applicable) Social Security Number: (optional)   Gift Information: Total gift or pledge amount:  $(U.S. Dollars) My gift is to be used for:   Credit Card Information:(If not sending check or money order) Credit Card:  Master Card Visa Credit Card Number:  Expiration Date: Name on Credit Card: (as it appears on card)   Gift Credit to Spouse: Are you married to a Syracuse University Graduate? YesNo If yes, would you like half of your gift/pledge credited to your spouse? YesNo Name of Spouse: Social Security Number: (optional) Class year:   Matching Gifts: Does your employer participate in a matching gift program? YesNoNot Sure If so, please indicate your company's name and mail your form to the Matching Gift Administrator at the above address. Company Name:   Comments or Questions: For more information call 315-443-2622. Thank you for supporting the Collegiate Science & Technology Entry Program @ Syracuse University!

Collegiate Science and Technology Entry Program (CSTEP) Office of Graduate Preparation Programs 804 University Avenue, Suite 303 Syracuse, New York 13244-2330 Phone: 315-443-2622 Fax: 315-443-5683 Email: cstep@syr.edu For technical assistance, contact our webmaster webmaster@CustomWebHelp.com Site by www.CustomWebHelp.com © 1995-2004 Syracuse University  All Rights Reserved.