University of Wisconsin Foundation

US Bank Lockbox

P.O. Box 78807

Milwaukee, WI  53278-0807

To make a gift, please make your check payable to the University of Wisconsin Foundation and mail it with this completed form to the University of Wisconsin Foundation. If you wish to use a credit card, fill out the information below, sign and mail to the Foundation address.

I/we wish to support ongoing programs for educational excellence at the University of Wisconsin-Madison with my/our contribution of $ ____________.

A matching gift program can double or even triple your gift to the UW-Madison. If you wish to have your gift matched by your employer, please fill in the name of your company below. If your program includes a printed form, please complete that form and include it with your gift and this form. For further information about your company’s matching gift program, please contact your human resources office. Company Name: ________________________________________

I/we wish to designate my/our gift to:
The Menahem and Claire Mansoor Endowment Fund (UW Foundation Account #12452686)

Name ____________________________________________________________________________

Address __________________________________________________________________________

City ___________________________________ State ___________ Zip _______________________

Home phone ____________________________

E-mail address ___________________________

___ Check here if this is a new address

Credit Card Information

Please circle your credit card type:     MasterCard         Visa         American Express

Card Number _______________________________ Expiration Date ____________________

Cardholder name (please print) __________________________________________________

Cardholder signature: __________________________________________________________

We thank you for your continued support and encourage you to call

the University of Wisconsin Foundation, #608-263-4545, whenever

you have a question or need information about making a gift.