FSSF 09-10 Donation Form UPDATED Nov 5 by doc5671


									               Fordham Student Sponsored Fellowship
                               Fordham University School of Law

                 19th Annual Public Service Auction (March 4, 2010)

                                      Donation Form
Name or Company Name ­_____________________________ Graduation

Address ______________________________________ City

State ____ ZIP __________ Phone _________________ E-mail

Contact Name & Number/E-mail (if different from above)

Authorized Signature _________________________________ Date

      **Please return this form to the address at the bottom of the page by February 1, 2010.

       We welcome all contributions, but those received after February 1 may not be listed

              in the Auction Catalogue and will be included in the Supplement instead.

                                       Type of Donation


I and/or my company will donate the following goods or services to the 2010 Auction:


The approximate value is $_________

Donation in form of gift certificate? ( ) Yes If so, donor provides gift certificate: ( ) Yes
OR… donor authorizes gift certificate to be written by Fordham ______ (initial)


I and/or my company will become a patron by donating $_______. In return, my name and/or
my company’s name will appear in the Auction Catalogue.

                           Donation                          Category

                 ____           $4,000 and up                           Fellowship Platinum Circle

                 ____           $1,000 and up                           Fellowship Gold Circle

                 ____           $500 and up                          Dean’s Circle

                 ____           $250 and up                          Benefactor

                 ____           $100 and up                          Sponsor

Please list in Auction Catalogue: ( ) My name OR ( ) Company’s name OR ( ) Both


I and/or my company will become an advertiser in the Catalogue. (Please see attached sheet for

                 Fordham Student Sponsored Fellowship at Fordham Law School

                              140 W 62nd St., New York, NY 10023

                    T: 212-636-6971     F: 212-636-6744   fssf@law.fordham.edu

                         Donate and purchase tickets online at www.fssf.org

Size        Price

____          Position page (8.5” x 11”)         $2,500

____          Full page (8.5” x 11”)          $1,000

____          Half page (8.5” x 5.5”)         $500

Size        Price
____          Quarter page (4.25” x 5.5”)           $275

____          Eighth page (4.25” x 2.75”)           $100

*A business card is a good design for 1/8 pg. ad.

                                    Payment Information

Check enclosed? ( ) Yes (Please make checks payable to Fordham Student Sponsored Fellowship)

OR… payment by ( ) Mastercard ( ) Visa in the amount of:

Credit Card Number: _______________________________________ Expiration Date:

Authorized signature ___________________________________________ Date

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