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Make a GiftPlease fill out this form and mail to the address provided below. Click here for a PDF version of this form. Pledges may be made payable over 1 to 5 years. A gift agreement form will be mailed to you. Donor Information (please print): Name________________________________________________________ Street________________________________________________________ City State Zip__________________________________________________ Phone_______________________________ Email________________________________ ___ I wish to make a pledge in the amount of $______________ ___ I have enclosed my/our employer’s matching gift form. ___ Please send information about including the Department of Microbiology and Immunology in my estate plans. ___ Please contact me with more information about gift opportunities. Enclosed is my gift in the amount of: ___$5,000 ___$2,500 ___$1,000 ___ $500 ___ Other $____ ___ Check enclosed payable to the University of Michigan Please charge my gift to: ___Mastercard ___Visa ___ Discover ___AMEX Card No. ________________________________ Exp. Date ___________ Signature I would like my gift to be directed to the following area of research: ___ Unrestricted ___ Dr. Frances Wang Chin Endowed Fellowship (704755) ___ Frederick G. Novy Fellowship (720850) ___ Frederick G. Novy Library Fund (720860) ___ Ward J. MacNeal Educational and Scientific Memorial Trust (717915) ___ Dr. Clayton Willison and Emma Elizabeth Willison Fund (729756) ___ William Warner Brockman Memorial Fund (361604) ___ Herbert and Ethel MacNeal Endowed Student Aid Fund (G05035) ___ Michigan Infectious Diseases International Scholars Private support is vital to our ability to advance research and provide opportunities to our graduate students in the Department of Microbiology and Immunology. Your gifts are tax deductible as provided by law. Mail to:
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