Name(s):

Address:

City, St Zip:

Phone: E-mail:

I wish to contribute: To the Student Legacy Scholarship $

To Mary Idema Pew Library Learning and Information Commons $

To the Shaping Our Future Campaign $

To this designated fund: $

Total gift amount: $

My method of payment:

Check enclosed payable to Grand Valley State University

Please bill my credit card (VISA, MasterCard, American Express or Discover)

Card#:

Expiration Date: / Security code:

Signature:

Gift Form for GVSU Students

This code is the last 3 digits in the signatureblock on back of card.

Please complete this form and return it with your check or payment information to:

Grand Valley State UniversityUniversity Development301 Michigan St. NE Ste 100Grand Rapids MI 49503-3314

You can make a gift by calling (616) 331-6000 or by using our secure website at: www.gvsu.edu/give

Your gift to Grand Valley State University is tax deductible and may qualify for a tax credit

Additional Contact Info

Phone: (616) 331-6000

Fax: (616) 331-6099

Email: giveto@gvsu.edu

Gifts are recognized by

Grand Valley State University

according to these clubs:

$ 25,000 or more Governor$ 10,000 - $ 24,999 Trustee$ 5,000 - $ 9,999 President$ 2,500 - $ 4,999 Provost$ 1,000 - $ 2,499 Dean$ 300 - $ 999 Leadership

5+ consecutive yearsat any giving level Lubbers Society

Levels of Recognition

Grand Valley encourages giving to the Shaping Our Future Campaign as well as Annual Giving to funds such as the Grand Valley Fund. Gifts during the campaign, from July 1, 2007 to the campaign conclusion, will count toward the total we will celebrate during our 50th anniversary year in 2010-2011.

Shaping Our Future

Campaign

www.gvsu.edu/shapingourfuture

WEB