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Penn State Faculty and Staff Contribution Form

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Penn State Faculty and Staff Contribution Form Penn State Faculty and Staff Contribution Fo rm Dr./Ms. Mrs./Mr. Name: First Middle Last Unit/College/Campus Home Address Campus Address City City State Zip Title Email I am a Penn State graduate, class of Home Phone If alumna and married, please enter your name before marriage if Penn State ID Number different from your present name Gift Designations See suggestions on reverse Enter the designation(s) for your gift and the portion of your gift that each should receive. (Please make sure the individual gift amounts equal your total gift.) 1._________________________________________________________________________________________________ $____________ .00 Designation (Please specify location if other than University Park Campus) Amount per pay period* 2._________________________________________________________________________________________________ $____________ .00 Designation (Please specify location if other than University Park Campus) Amount per pay period* 3._________________________________________________________________________________________________ $____________ .00 Designation (Please specify location if other than University Park Campus) Amount per pay period* Total (all designations/pay period) ............................................................................................................................... $____________ .00 Total per pay period *Amount per pay period if payroll deduction, otherwise total of gift per designation Three Ways to Make a Gift I Payroll deduction I a new payroll deduction donor Effective with next pay period, deduct $_____________.00 per pay period I Biweekly Payroll I Monthly Payroll (Please use whole dollar figures for each gift; minimum payroll deduction $5 per pay period) Changes to current deductions I changing the dollar amount of current deduction(s) I adding a designation to current deduction(s) I changing the designation of current deduction(s) I stopping payroll deduction(s) This authorization shall remain in effect until you notify the Office of Annual Giving that you wish to change or stop the payroll deduction. I Check — I am enclosing a check payable to Penn State for $______________.00 I Credit Card — Please charge my credit card in the amount of $______________.00 I Visa I MasterCard I American Express I Discover Signature (needed for credit card or payroll deduction ) Date Name as it appears on credit card Account Number CVV Exp. Date At University Park campus return to: At other locations return to: Office of Annual Giving The Director of Development at your location. 200 Bristol 1 University Park, PA 16802 AD30A Areas that can Benefit from Your Gifts Unrestricted gifts University Libraries Unrestricted gifts, those not donor-designated for a specific use, are Gifts enable purchases of books and journals, various types of technology especially important to Penn State. They broaden the scope of program information resources, and the preservation of collections. enrichment by enabling the University to provide funds where the need is greatest. Intercollegiate Athletics Gifts support more than 800 student-athletes on 31 men’s and women’s College and Campus Programs varsity sports teams. By joining the Nittany Lion Club you Opportunities for giving are plentiful at all Penn State locations. All recog - support athletic scholarships. Penn State Athletics receives no state or uni - nized programs, research projects, and activities can be measurably versity funding to operate the program. helped by faculty and staff support. WPSU Trustee Scholarship Program Membership gifts support the programs and services these public broad - Each undergraduate college and campus has a general Trustee Scholarship casting stations provide to Penn State and central Pennsylvania. Fund. The University will match 5 percent of gifts made in support of these scholarships at the campus or college of the donor’s choice. This scholar - Shaver’s Creek Environmental Center ship fund will provide aid to students with significant financial need. For As Penn State's nature center, Shaver's Creek reaches thousands of people more information about the program and general unit funds visit annually through traveling animal programs, field trips for school groups, www.giveto.psu.edu/trustee. public nature programs, and by teaching more than 30 university courses. Gifts support the care of injured and non-releasable hawks and owls at the Undergraduate and Graduate Student Support Raptor Center, program scholarships for youth, college internships and Many talented students have received exceptional educational opportuni - landscape stewardship. ties as a result of Penn State’s commitment to providing outstanding edu - cational programs at costs that are accessible to all students, regardless of Arts Programs their financial means. Renaissance Fund, College, or Campus scholarships Contributions may be made to the Center for the Performing Arts, Palmer and other resources for undergraduate and graduate students, provided by Museum of Art, Penn State Centre Stage, Music at Penn’s Woods, and many your gifts, enhance the quality and accessibility of a Penn State education. other programs in the arts including the Blue Band, which qualifies donors to be members of the Floating Lions Club. Faculty Support Support of Penn State faculty and faculty programs include giving to a Employee Assistance Fund (EAP) dean’s chair, department head’s chair, faculty chair, faculty fellowships, or Gifts to this fund will provide financial support for faculty and staff facing a professorship awards. wide range of personal or family hardships. The fund enhances the quality of life and improves the mental, emotional and physical well-being of Penn State College of Medicine/Penn State Hershey employees and members of their household during difficult circumstances. Medical Center There are many opportunities for support including gifts to the Penn State The Arboretum at Penn State Children’s Hospital, Penn State Cancer Institute, Penn State College of Medicine A gift to the Arboretum will help Penn State to build one of the nation’s Endowed Scholarship Fund, and the Penn State Hershey Medical Center General finest university arboreta. When completed, the Arboretum will feature Research Fund. over 50 acres of cultivated gardens, a conservatory, and an education cen - ter next to Park Avenue, and encompass more than 300 acres of restored woodlands. Recognition Societies The President’s Club Mount Nittany Society Join Penn State donors who give $2,500 or more per fiscal year. This can Individuals who have cumulative giving to the University of at least be accomplished with a payroll deducation of $209 per month. $250,000 are members. Gifts can be made through any combination of the following means: outright gifts, matching gifts, irrevocable commitments Donors who are 35 years of age or younger become members with or gift annuities. gifts totaling $1,500 or a monthly payroll deducation of $125 (based on age of younger spouse/partner). For more information, Atherton Society www.giveto.psu.edu/presidentsclub. Membership is offered to all individuals who have made an estate provision for Penn State, or a planned or deferred gift commitment, regardless of the amount. Other Ways to Give Gift Planning Matching Gifts If you are interested in income-producing gift plans, bequests, gifts of appreciat - If you or your spouse are eligible for a corporate matching gifts program, ed securities, retirement plan designations, or other planned giving opportunities, please contact the company to arrange to have your gift matched. contact the Office of Gift Planning at 1-888-800-9170. Visit our Web site at: Visit www.matching.psu.edu to see if your company matches gifts to www.giftplanning.psu.edu. Penn State. Questions? Please direct any questions about faculty and staff giving to Liz King at 814-863-2052 or by e-mail at [email protected]. More information and extra copies of this form are available online at: www.giveto.psu.edu/facultystaff Thank you for your support of Penn State. The Penn State Annual Fund Phone: 814-863-2052 www.giveto.psu.edu 200 Bristol 1 Fax: 814-865-8755 University Park, PA 16802 E-mail: [email protected] h v t 2 3 8 2 2 1 C P M.
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