You can make a gift to Piedmont College by filling out the following form. If you wish to make
a gift by mail, please include this form in your envelope. For assistance, call the
Office of Institutional Advancement at 1-800-868-1641 or 706-778-3000 ext. 1174.

First Name: *

Last Name: *

Email Address: *

Name at Graduation:

Piedmont Class Year:

Spouse's Name:

If spouse an alum,
include class year:

Name as you wish it
to appear for donor
recognition:

I will mail my company's
matching gift form.

Mail form to:
Susan Mills
Piedmont College
P.O. Box 429
Demorest GA 30535

Do you wish for your gift to be anonymous?

Yes

No

If this gift is in HONOR or MEMORY of someone,
please complete this section of the form

Honor

Memory

Name of Individual(s):

Relationship:

Would you like Piedmont to notify the honoree or family of the above gift?

Yes

No

If yes, please complete the following:

Address:

City:

State:

Zip:

The next page will allow you to enter the dollar amounts for your gift.