Giving to the UCLA Library - Honor With Books

Donor Information

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

Business

Home telephone:

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Business telephone:

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E-mail address:

This e-mail is my:

Home

Business

Gift Options

Matching Gift

Click here to find out if your company will match your gift.

My/my spouse's employer will match my gift.

Company name for matching gifts:

This company is:

My employer

My spouse's employer

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.

My gift is made:

In honor of

In memory of

*Person and/or occasion:

Given by (leave blank if you do not wish your name to be printed on the bookplate):

*Bookplate Design:

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*Book Subject:

Please note, we cannot send a tribute acknowledgment if we do not have the acknowledgee's name and contact information. If this gift is in memory, please provide the name and contact information of the person who should receive an acknowledgment from UCLA using the following section.

Please Notify:


	Title:
	First name:
	Middle name:
	Last name:
	Home address:

	For U.S. Addresses
	City, State, Zip:
	For Non-U.S. Addresses
	Non-U.S. City/County or Province/Postal Code
	Country:

	Telephone:
	E-mail address:

Payment

Payment method:

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Additional Information


	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: