The UCLA CORE Program which embodies the values of Clinical Excellence, Outreach, Research, and Education, is dedicated to providing the highest quality of patient care, performing cutting-edge research and educating patients and healthcare professionals about the latest advances. The Program’s success relies on the generous support of friends like you. Your gift will help ensure that UCLA can meet the ever-growing need for specialized training, research, and patient programs aimed at the prevention, treatment, and management of kidney disease and hypertension and our goal of finding a cure for kidney disease. Every gift makes a difference!


Required fields are indicated with an asterisk (*).
Your contribution is greatly appreciated!
*I would like to make:
   Other $  
(Contributions of $100 or more are eligible.)


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

Spouse/Partner
  Name:  

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 creating a scholarship or fellowship.
This gift is anonymous
 
Comments: