Contribution Form (Print and Return)

Contributions to the Department of Geography and Geology play an important role in helping our programs succeed. Your gift of any amount will help support Department initiatives in scientific education, research, and other important student activities.

Full Name _______________________________________________________

Mailing Address ___________________________________________________

City _______________________ State ___________ Zip Code _____________

Daytime phone ____________________ Evening phone ___________________

Fax ___________________ E-mail address ___________________

Please indicate the amount of your contribution below:

__ $25  __ $50 __ $100 __ Other _______

Method of payment:

__ My check is enclosed, payable to the WKU Foundation (designate specifically for the Department of Geography and Geology).

__ Please charge my credit card:

__ Visa __ MasterCard __ American Express __ Discover

Acct. Number _______________________ Exp. _________

Signature ________________________________________

Tax-deductibility: The WKU Foundation (and the Department of Geography and Geology) is recognized as a tax-exempt, nonprofit organization under section 501(c)(3) of the Internal Revenue Code. The WKU Foundation has been classified by the IRS as a public charity operated for the benefit of a state university as defined in the Internal Revenue Code of 1986 Section 170(b)(1)(A)(iv). Contributions to the Department of Geography and Geology through the WKU Foundation by individuals, corporations, organizations and other foundations qualify as tax deductions.