*Name:
Name on Credit Card if different:
*Home Address:
*City:
State:
ZIP Code:
*Phone:
Phone Type: Home Work Cell
*Email:
Company Name:
Title:
Company Address:
My Employer may match this gift:
I wish to contribute to the Nathan Manilow Sculpture Park as designated below:
$ New Acquisition Fund (started by Paul and Linda Uzureau)
$ Lewis Manilow Common Ground Initiative
$ Bill Dodd Memorial Prairie Restoration Fund
$ Outdoors@theNate Education Fund
$ theNate General Fund
$ Other
$ Tribute Gift
In Memory or Honor of:
Please send Tribute Donation acknowledgement to:
Name:
Address:
Please make my gift Anonymous
Once you hit "submit" below, you will be redirected to the Governors State University Foundation on-line donation form through Touchnet, our on-line secure payment provider.
Any questions please call (708) 235-7559.