We Appreciate Your Contribution

Please print and complete this form, and mail it along with your contribution check payable to SUAA Foundation.

SUAA Foundation

217 E. Monroe, Suite 100

Springfield, IL 62701

Donor Information

Name _____________________________________________________________________________________________

(Please write your name/s as you would like it to appear in print)

Address ___________________________________________________________________________________________

City, State, Zip ______________________________________________________________________________________

Email _____________________________________________________________________________________________

Please indicate type of donation:

Endowment Memorial Unrestricted Recognition

If your donation is a memorial for recognition, please list the individual/s on whose behalf the donation is being made: _____________________________________________________________________________________

_________________________________________________________________________________________________

Please notify the following individual/s of my gift:

Name _________________________________________________________________________________

Address _______________________________________________________________________________

City, State, Zip __________________________________________________________________________

Email ________________________________________________________________________________