UCC Foundation Pledge Form

The following form is provided to make a donation to the UCC Foundation. Your generous giving has a direct impact on our students and the community. Thank you for your consideration.

UCC Employees

UCC Classroom

UCC Students

Today's Date

Your Full Name

Your Full Address

Your Phone (Home)

Your Phone (Business)

Your Fax

Your Email

I want my gift to be anonymous

Pledge Information

I (we) pledge a total of

I (we) wish to have this donation spread over

If other, enter time period

Please bill me

Contribution Type

I (we) plan to make my (our) contribution in the form of

If other, please explain

Please direct my gift to:

Please choose from the items below to select which program(s) that you would like your donation to support. If you choose more than one item from the list below, please enter a percentage to indicate how your gift should be divided.

Area of Greatest Need

Percentage

Scholarship Support

Percentage

Student Support

Percentage

Other

Define other (Please list specific program or scholarship)

Percentage

Donor Recognition & Electronic Signature

Please use the following name(s) in acknowledgements

Please type your name to serve as an electronic signature

Please enter the code

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