On-line or Printable Gift Form

You can make a gift or pledge to Piedmont College by filling out the following form. If you wish to make an on-line gift, check the appropriate box at the end of the form. If you wish to make a gift by mail, fill out and print this form. You can then mail the form with your check, cash or credit card information to:

Office of Institutional Advancement
Piedmont College
P.O. Box 429
Demorest  GA 30535

Yes, I wish to support Piedmont College with a gift. The allocation is as follows:

Fund for Piedmont
Name of Fund	Amount	Designation
Unrestricted Support:	$
Student Financial Aid:	$
Library Holdings:	$
Named Scholarships:	$
Other:	$
	Total:$
Does this gift count toward an existing pledge? Yes No     If Yes, designation,
I wish my gift to remain anonymous. Yes No

Title	Choose Mrs. Mr. Miss Ms. Dr. Rev.
First Name
Middle Name
Last Name
Birth/Maiden Name
Address
City
State
Zip
Home Phone
E-mail address
Piedmont Class Year
Spouse's Name
Spouse an Alum?	Yes No
Name as you wish it to appear for donor recognition.
I will mail my company's matching gift form to:             Nancy Singer             Piedmont College             P.O. Box 429             Demorest GA 30535

If this gift is in honor or memory of someone, please fill out this part of the form.
Honor	Memory
Name of Individual(s)
Relationship
Would you like for Piedmont to notify the honoree or family of the above gift? Yes No    If yes, please complete the following

Name of Individual(s)
Address
City
State	None AL AK AS AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VI VA WA WU WI WY
Zip