Use this form to make an on-line gift to the campaign using your credit card. If you prefer to make your gift in another manner, we offer other ways to give.
Please supply the information requested below. Required fields are marked with an asterisk (*).
You will then be transferred to the secure site of our on-line giving partner, Verisign, to enter your credit card information.
*Name, as it appears on credit card:
Credit card billing address:
*Street:
*City:
*State:
Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware 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 Virgina Washington Washington, D.C. West Virginia Wisconsin Wyoming
*Zip:
Country:
New Address?
Yes No
*Phone:
Fax:
*Email:
Class Year, if Alum:
Allegheny Parent?
Maiden name (optional):
Employer:
Is your employer a Matching Gift company?
*Gift amount:
$ .00
Please use my gift for: Student Support Faculty Support Academic Program Residential College Campus of the Future Annual Fund
