I. Personal Information
Title:
Mr.
Mrs.
Ms.
Miss
Dr.
Rev.
Rev. Dr.
Other
First:
Middle:
Last:
Suffix:
None
Jr.
Sr.
Ph.D.
Other
Spouse's
Full Name (if applicable):
Title:
Mr.
Mrs.
Ms.
Miss
Dr.
Rev.
Rev. Dr.
Other
First:
Middle:
Last:
Address: (This
needs to be the same as the billing address for your
credit card.)
Type
of Address:
Home
Business
Other
Address
1:
Address
2:
City:
State:
Select a State
----------------
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
----------------
American Samoa
Guam
Puerto Rico
Virgin Islands
Zip:
Country/Nation:
Daytime
Phone (including area code):
Home
Business
Other
Evening
Phone (including area code):
Home
Business
Other
Email:
Home
Business
Other
(Email
and phone information help us in case we have questions
about your gift.)
ANTS
Affiliation:
alumnus/a
faculty/staff
friend
student
If
ANTS alumnus/a, please also tell us:
Last
year of study at ANTS:
2.
Gift Details:
Gift
amount (in US Dollars):
$25,000
$15,000
$10,000
$5,000
$2,500
$1,000
$500
$250
$100
$50
$25
Other:
3. Matching Gifts
Many employers match the donations their current and
retired employees (and employees' spouses) make to higher
education. If your company has a matching gift program,
your gift could be increased (maybe even doubled) -
at no additional cost to you. Please check with your
benefits, human resources, or community relations office
to see if your employer has a Matching Gift program.
This gift is eligible to be matched:
Company
you work for:
Company
your spouse works for:
Please
mail a Matching Gift Form from the matching company
to:
Andover
Newton Theological School
Office of Institutional Advancement
Attn: Gift Coordinator
210 Herrick Road
Newton Centre, MA 02459
4. Memorial Gifts
If you would like to make this gift a memorial contribution, please enter for whom.
Memorial Gift for:
5. Payment
Credit
card Type:
Visa
Master Card
Credit
card Number:
Credit Card Security Code:
The last 3 digits in the strip on the back of card
Name
as it appears on card:
Credit
card expiration date:
Month:
Year:
6. Comments
7. Inquiry for Planned Giving Information
Please have someone contact me about how estate planning
can help me prepare for the future while making a significant
gift to Andover Newton Theological School.
8.
Submission
I have checked the information above and wish to submit my gift.
or: I still wish to make a gift but need assistance .
Thank you for your support of Andover Newton Theological School.
If you have further questions or would like additional information
about Andover Newton or the ways you can give, please contact us at:
Office of Institutional Advancement
210 Herrick Road
Newton Centre, MA 02459
(800)964-ANTS