Dakota Wesleyan University Printable Gift Form
Please print this gift form and mail it along with your donation/pledge
to the address specified at the bottom of this page.

Name(s) as they should be listed on the gift receipt: Please print

______
Prefix
_________________
First
______
Middle
________________________
Last
______________________
(Maiden)
Mailing Address _______________________________________________________
City______________________________ State___________ Zip Code________________
Telephone ( _____ ) _______________ E-mail address_______________________________
I am a:

Alumnus (a)
Grad year:
_______________
DWU Parent
Student’s Name:
_________________________
Friend    

    
Gift Information
(
All gifts are deductible for tax purposes.)
    

A check for my gift of $___________ is enclosed.   (Checks should be made payable to DWU.)

     

Please charge my gift of $___________________ to the following credit card:

Circle one:  VISA    MASTERCARD    DISCOVER   Expiration Date: ____________

Account #: __________________________Signature: _______________________________
    

I wish to make _____ (#) payments of $ ______________   for a total of $ _______________
pledged. Please bill me in:

Jan.

Feb.

Mar.

Apr.

May

June

July Aug. Sept. Oct. Nov. Dec.
               

Gift Designation

Please credit my gift to the Wesleyan Fund
John Wesley Society
     $1,000 or more
Stewardship Society
     $500 to $999
Benefactor's Society
     $250 to $499
Founders' Society
     $100 to $249
Or credit my gift to the following fund:
Endowed/Annual Scholarship gift to:

______________________Scholarship

Other Gift:

________________________________

If your gift can be matched by your employer’s matching gift program, please check
with your personnel or benefits office for details and the proper form to enclose.

Please return this form, along with your contribution/pledge to:
DWU- Institutional Advancement
1200 W. University Ave.
Mitchell, SD 57301