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If you have any questions about this donation, please contact:

Jennifer Brown
UCLA Health Sciences Development
(310) 206-2435
JenniferVBrown@mednet.ucla.edu
* I would like to make
(Contributions of $1000 or more are eligible.)
Gift Selection(s):
DesignationAmount
Dr. David McAllister Education Fund
Dr. Sharon Hame Discretionary Fund
Dr. Frank Petrigliano Discretionary Fund
Sports Medicine-Dr. Gerald Finerman
Total

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
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 interested in learning more about how I can include UCLA in my estate plan.
This gift is anonymous.
 
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