Give Online Now I would like to make: a new one time or recurring gift a payment on an existing pledge * Frequency: One time Weekly Monthly Quarterly Annual Recurring Amount: $ Start Date: End Date: Your recurring gift will be split between multiple colleges and/or programs accordingly below. * Peoplesoft ID: * I'd like to make a gift of: $15 to receive a spirit cord $20.19 in honor of my class year $5 to receive a phone wallet $15 to receive a spirit cord $20.19 in honor of my class year Other $ I would like to accept a Cougar Spirit Cord and understand that the charitable portion of my gift may be reduced. No, I do not want a Cougar Spirit Cord. Please use my entire gift for charitable purposes. * Please designate my gift to: Total gift amount: $ Please let us know if you would like to designate your gift further (for example, to a department within a college or in honor or memory of someone) or give us any other special instructions about your gift. This gift is in memory of: This gift is in honor of: Donor Information Do Not publish my name on any recognition lists Title: Please choose... Airman First Class Baron Brigadier General Captain Colonel Dean Doctor Father First Lieutenant General Governor Judge Lieutenant Lieutenant Colonel Lieutenant Commander Major Miss Mr. Mrs Ms. Professor Rabbi Sergeant Sergeant Major Sister The Honorable The Most Reverend The Reverend * First name: Middle name: * Last name: Suffix: * Address: * City: * State/Province: * Zip code: * Country: * Phone number: * Email address: Date of birth: Spouse's full name: Applied for Graduation Status: UH Alumnus None UH degree: Graduation year: * Peoplesoft ID: Do you or your spouse work for a matching company? Yes No I work for a matching gift company Company name: My spouse works for a matching gift company Spouse's company name: Send your completed matching gift form to: Matching Gift Administrator Gift Processing and Records University of Houston Houston, TX 77204-5035 Would you like to update your business information? Yes No Job title: Employer: Address: City: State/Province: Zip/Postal code: Country: Phone number: Email address: Have you already or would you like to include UH in your estate planning? Yes No I have already included UH as a beneficiary of my: Will Trust Life Insurance Policy Retirement Assets Annuity IRA Please send me information for the following: Bequest Language Membership in The Tempore Legacy Society Ways to Make Planned Gifts Charitable Gift Annuities Estate Planning Kit Information provided on this form will be used by University Advancement for the purpose of crediting you correctly for your gift. Personal information contained in University Advancement's records is used only for university business. We are committed to protecting your privacy. Our secure server software (SSL) is the industry standard and among the best software available today for secure commerce transactions.