Thank you for your interest in supporting UCLA Tiverton House. It was designed to offer convenient, affordable housing for UCLA Health System’s patients and their families during times of medical emergencies or prolonged treatments, with knowledgeable and compassionate staff available 24 hours a day, 365 days a year.
  • UCLA Tiverton House - Housing Assistance
    The Housing Assistance Program eases the burden of financial worry for qualified UCLA patients and their families by finding and financing temporary and low-cost housing options.

  • Tiverton House Equipment and Facilities Fund
    The Equipment and Facilities Fund supports both new and existing projects and renovations within the hotel and on its grounds.



Required fields are indicated with an asterisk (*).
*Please direct my gift to the following fund:
   
*I would like to make:
   Other $  
(Contributions of $2500 or more are eligible.)


Personal
Title:
 
* First name:  
  Middle name:
* Last name:  
  Suffix:
UCLA graduation year(s):  

Spouse/Partner
  Name:  
  UCLA graduation year(s):

Joint Gift
* This is a joint gift with my spouse/partner:
 

Contact Information
* Street:  
 
U.S. Addresses  
*   City, State, Zip:
 
 
 
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
 
  Country:
 
* This address is my:  
* Home telephone:    
Business telephone:  

* E-mail address:  
* This e-mail is my:  

Matching Gift

  My/my spouse's employer will match my gift.
  Company name for matching gifts:
  This company is:
Tribute Gift
Please check this box if you would like to honor a family member, faculty member, business associate, community leader, or other with your contribution.
 
Payment method:
I am interested in learning more about how I can include UCLA in my estate plan
This gift is anonymous
I am interested in learning more about UCLA Tiverton House.
 
One of the ways we express our gratitude is by listing our donors' names in UCLA honor rolls. If you wish to exclude your name, please check this box.

 
Comments: