Nicholls Foundation

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

The Nicholls State University Foundation has established the Nicholls Campus Emergency Fund to assist students in times of unique needs.

All gifts, regardless of size, are appreciated. You are encouraged to make a gift that will challenge your giving and, if necessary, can be completed in increments best suited for you to make a great impact on Nicholls State University and its faculty and students.

$50

$100

$250

$500

$1,000

Other Amount

Choose A Frequency

Recurring Frequency:

Total: $0.00

Your Information

First Name: *

Middle(Initial) Name:

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Home Phone:

Mobile Phone:

E-mail: *

A receipt will be e-mailed to this address.

Additional Information:

Affiliation:

Alumni Class Year:

If alumni, enter preferred class year

Name of Spouse:

If Spouse is Alumni, Class Year:

If alumni, enter preferred class year

How would you like name to appear for donor publication:

If want to remain anonymous, please type anonymous in box above.

Comments:

PLEASE SEND NOTICE OF THIS GIFT TO:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *