Reaching New Heights
SFU Capital Campaign
2006 Campus Campaign
Name
Address Department
City, Province Postal Code
Phone Number Email
þ Yes, I want to support students at SFU!
Enclosed is my gift/pledge of:
r$150 r $200 r $350 r $500 r Other $ ______ to be paid over ______year(s).
Please direct my donation to:
r Campus Community Bursary Fund r Library Special Project
r Other (please specify department, office, program, project or athletic team)
To designate your gift to more than one area, write allocation amount beside areas of choice.
Payment options
A. Payroll Deduction (faculty and staff only)
r I authorize continuous bi-weekly deductions of $ starting on
(deductions will continue until otherwise notified)
r Deduct $ X pay periods starting on
SFU ID # (required for payroll deduction)
Signature
B. Alternative Method of Payment
r Cheque (payable to Simon Fraser University)
r VISA r MasterCard r American Express
Account # Expiry Date __/ __
Cardholder’s signature
Credit Card Gifts by Installment
r All at one time
r ____ monthly payments of $ starting on 1st, 2006.
(month)
r I would like to arrange other installment terms, please contact me.
Your donation qualifies for a tax receipt. Receipts for payroll gifts are included on T-4 slips; University Advancement will issue receipts for cash gifts. Charitable Business Number #118520725RR0001
r I prefer that my gift remain anonymous.
r Please send me information about including SFU in my will.
Privacy Statement
At Simon Fraser University, your privacy is our priority. We adhere to all legislative requirements with respect to protecting privacy. We collect your information under the University Act to administer our university advancement program and fundraising campaign. The information we collect is used only to process donations, keep people informed about our activities, and ask for support to further our work. We do not disclose your information to other organizations. If at any time you wish to be excluded from any such contact, or if you have any questions about our privacy policy, please contact Wanda Dekleva at (604) 291-3093.
Please return form to:
SFU, University Advancement, 2100 Strand Hall, 8888 University Drive, Burnaby, BC V5A 1S6