Yes, I want to Support #DUGivingTuesday!!
By signing up for a pre-arranged gift to support #DUGivingTuesday, you are reserving your donation to be processed on or BEFORE November 28, 2017. Your information will be safely stored and discarded upon processing the gift, and you will receive a notification on the day the donation is made, and a receipt for the full amount of your gift. Let's take the hassle out of giving! We'll do all the work to make your commitment count!


Learn more about #DUGivingTuesday at http://bit.ly/2017DUGivingTuesday
Sign in to Google to save your progress. Learn more
Donate. Impact. Invest!
First and Last Name *
How much would you like to donate on #DUGivingTuesday? *
Please specify how much you would like to donate. Your gift will be processed on November 28.
On what day would you like your #DUGivingTuesday support gift to be processed? *
Please provide a date prior to or on November 28, 2017. (00/00)
Would you like this gift to be recurring? *
Full name as it appears on the card *
Card Number *
(****-****-****-1234)
Expiration Month/Year *
Two digit month, two digit year. (**/**)
Card Security Code *
Billing Address *
Please include your address number and street name.
Apt/Unit Number
(if applicable)
City *
State *
Zip Code *
Cell phone number *
Email Address *
Special notes about your gift.
Your gift will be applied to areas most needed, unless otherwise specified.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dillard University. Report Abuse