Gift Intention Form : Giving to Texas State University : Texas State University

Donor(s) Name(s) *

Gift Amount *

By checking this box, I acknowledge a commitment to give or cause to be given to Texas State University Development Foundation of the amount specified above. *

I acknowledge this commitment.

These funds shall be designated to support the following program, fund, or facility. *

University's Greatest Need

Other

Please list the specific program, faculty, or fund.

Gift Type *

One-Time Gift

Gift Pledge (payable up to 5 years)

Recurring Gift

Blended Gift

Planned Gift

Texas State University has been included as a beneficiary of a:

Will or Living Trust

IRA or other Retirement Account

Charitable Gift Annuity

Life Insurance Plan

Other

Other:

Please leave blank if not applicable.

Payment Information *

Gift will be made by:

Cash

Check (payable to Texas State University)

Credit Card (information to be collected later)

Is this a recurring gift or gift pledge? *

Yes

No

Payment Schedule *

Monthly

Quarterly

Annually

Other

Please leave blank if not applicable.

Gift Recognition *

This gift may be publicized to encourage others to contribute.

The gift is anonymous and may not be publicized.

Is this a tribute gift? *

Yes

No

Tribute

In honor of

In memory of

Name

Send notification of tribute to:

Please input name, email, and address of person(s) you would like notified.

Donor Information *

Please select title.

Mr.

Mrs.

Ms.

Mx.

Dr.

The Hon.

Name *

Address *

City *

State *

Zip Code *

E-Mail *

Phone *

Spouse Donor Information

If no spouse, please leave blank.

Mr.

Mrs.

Ms.

Mx.

Dr.

The Hon.

Name

Address

City

State

Zip Code

E-Mail

Phone