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Wells College - Gift to Wells College Step 1: Gift Information Giving Level: select a level... Henry Wells Club ($25000) Aurora Society ($10000) Tower Society ($5000) E.B. Morgan Club ($2500) Sycamore Club ($1000) Cayuga Club ($500) Minerva Society ($250) FARGO Leaders ($150) Stagecoach Club ($100) FARGO Friends ($50) Stagecoach Club ($50) Stagecoach Club ($25) Stagecoach Club ($10) Other ($0) OR enter a specific amount below $ (required) Gift Designation: select a designation... Annual Fund Other Athletics Scholarships Science Facility If Other, please specify below Please provide any additional information that will help us process your gift correctly. Step 2: Personal Information Your relationship to Wells: choose all that apply Alumna Spouse/partner/widower of alumna Parent Faculty/Staff Friend First Name: (required) Last Name: (required) Your name while at Wells (if alumna): Class Year (if alumna): Address (line 1): (required) Address (line 2, or Province): City: (required) State: Select One Not Applicable Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Zip Code: Country: Select One United States Afghanistan Albania Algeria Andorra Angola Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belarus Belgium Belize Benin Bermuda Bhutan Bosnia-Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Chad Chile China Columbia Comoros Congo Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecaudor Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatamala Guinea Guinea-Bissau Guyana Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Morocco Namibia Nepal Netherland Antilles Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine Panama Papua-NewGuinea Paraguay Peru Phillipines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts-Nevis Saint Lucia Saint Vincents & Grenadines San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovak Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Trinidad & Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United States United Kingdom US Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Western Samoa West Indies Yemen Yugoslavia Zambia Zimbabwe (required) Postal Code (for non-US address): Home Phone: No dashes or spaces. (required) Work Phone: No dashes or spaces Email: (required) Step 3: Matching Gift Information Do you work for a company that matches gifts to colleges? You can double or triple your gift to Wells College if you or your spouse/partner work for one of over 1,000 companies. Check with your human resources office and send the matching gift form to: Gift Accountant Development Office Wells College Aurora, NY 13026 1 I am eligible for matching funds through my employer and will send you the form for processing 2 I have applied directly with my employer for matching funds 3 I am unsure if my employer matches gifts. If you chose #2 or #3 above, please provide the employer name: Next... Your credit card will only be charged the amount of your gift as noted in Step 1. Matching gifts will not be charged to your credit card. The Wells College fund year ends June 30. Credit card gifts must be made by 5:00 pm EST, June 30 to receive fund year gift credit. Credit card gifts must be made by 5:00 pm EST, December 31 to count toward the current tax year Return to Wells College Home Page Wells College Aurora, NY 13026 315-364-3266

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