Thank you for supporting UCLA Extension! We are a self-sustaining entity and we depend on private contributions to help us provide student scholarships, create new leading-edge programs and develop unique opportunities for student growth and engagement.

If you have any questions about this donation or to learn more about UCLA Extension, please contact Olivia Lam at 310-206-5255 or olam@uclaextension.edu.



Required fields are indicated with an asterisk (*).
* I would like to make

Gift Selection(s):
DesignationAmount 
Osher Lifelong Learning Institute Support Fund Remove
Total  

Personal
Title:
 
* First name:  
  Middle name:
* Last name:  
  Suffix:
  Birth date (mm/dd/yyyy):
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 the parent of a current UCLA student
  Student name:
  Anticipated graduation year:
I am interested in learning more about how I can include UCLA in my estate plan
I am interested in learning more about creating a scholarship or fellowship.
This gift is anonymous
 
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