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JHU Gift Designations
	Please Select or Enter Gift Amount $50 $100 $250 $500 Other Please Designate My Gift to Support Gift Amount $	Item weight

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Donor Information

Do you want to make this gift anonymous?

Yes

Salutation

First Name

Middle Initial

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Country

Email Address

Phone Number

Type

Phone Number

Type

Best time to call

Gift Options

Is this a joint gift with your partner / spouse?

Yes

To give this gift jointly with another individual please include the following information

Full name of the individual

Relationship to the individual

Gift Options

Is this a gift in honor or in memory of someone?

Yes

In Honor Of

In Memory Of

Honoree

At your request, we will notify the designated party that a gift has been made in his/her honor.
For memorial gifts, we will notify the family. Please fill in the contact information below if you would like notification to be sent.

Contact Information

Gift Options

Will your company match this gift?

Yes

Click here to search if your employer will match this gift.

If your company will match this gift please include the following information.

Company Name

Gift information has been submitted to my company's matching gift program

Yes

Matching Gift Ratio (if known)

Matching Gift Amount

Please send matching gift form to:
JHU/Development Business Services
Attn: Gift Processing Supervisor
3910 Keswick Road N2100
Baltimore, Maryland 21211

Questions about matching gifts? Please email matchinggifts@jhu.edu

Donor Comment

Comments

Payment Information

What payment method would you like to use?

Credit Card

Checking / Savings

Card Number

Card Number REAL

: Month

: Year

Security Code

Please select your account type

Checking

Savings

Routing Number

Account Number

Confirm Account Number

Payment processing may take up to 3-5 banking days to settle and post to your account. Only U.S. Domicile Accounts are accepted.

Check if the Billing Address is different from the address entered above

Billing Address Line 1

Billing Address Line 2

City

State

Zip Code

Country

Gift Frequency

Pledge Amount?

Total

If you have questions regarding this gift, please feel free to contact us at: (240) 228-2727 or email us at aaccbfsascholarship@jhuapl.edu

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