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Donation Form

Please Designate Your Gift To:

If more than one designation is specified, your gift will be divided equally unless other instructions are provided in the comment section below.

J. Keith Motley Inaugural Scholarship

Athletics

College of Liberal Arts

College of Management

College of Nursing & Health Sciences

College of Public & Community Service

College of Science & Mathematics

Graduate College of Education

Healey Library

McCormack Graduate School of Policy Studies

Scholarships

The Gaston Institute for Latino Community Development and Public Policy

Area of Greatest Need

Other:

Personal Information

First Name:

Last Name:

Middle Initial:

Address:

City:

State / Province:

Country:

Zip / Postal Code:

Home Phone:

(Ex: 617-287-5000)

Work Phone:

(Ex: 617-287-5000)

Class Year:

Major:

Email address:

How would you like to provide your gift:

Would you like to provide a monthly gift?

Yes

What is the gift amount you would like to contribute?

What is the gift amount you would like to contribute each month?

How many months would you like to contribute ?

Would you like this to be a joint gift?

Yes

Is this your spouse?

Yes

Name:

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City:

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Country:

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Memorials And Honorariums Information

I would like this gift to be:

in memory

in honor

Name:

Address:

City:

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Country:

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Additional dedication:

Yes

I would like this gift to be:

in memory

in honor

Name:

Address:

City:

State/Province:

Country:

Zip/Postal Code:

Comments:

Check this box if this gift is being made in response to a video email from UMass Boston

Thank you for your generosity.

The Mauricio Gastón Institute for Latino Community Development and Public Policy
University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125-3393
Phone: (617) 287-5790- Fax: (617) 287 - 5788 Email: Gaston.feedback@umb.edu

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