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UCLA Labor Occupational Safety and Health (LOSH) Program

UCLA-LOSH is proud to support campaigns in the community to improve workplace and environmental health and safety conditions through education, community research, and policy advocacy. Funding for all LOSH programs is generated from external sources. We welcome your support through tax-deductible financial contributions. Thank you for your ongoing support of LOSH programs and we look forward to continued collaboration to improve worker health.




Required fields are indicated with an asterisk (*).


If you have any questions about this donation, please e-mail Peter Evans, Senior Associate Director of Development, at pevans@support.ucla.edu.
Your contribution will help fund the UCLA Labor Occupational Safety and Health (LOSH) Program.
*I would like to make:
  Other $
(Contributions of $100 or more are eligible.)


Personal
Title:
* First name:
  Middle name:
* Last name:
  Suffix:
   I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor
  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:
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.
This gift is anonymous.
 
Comments: