Newman Center at West Chester University

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for supporting the 9th Annual Friends of the Newman Center Dinner/celebration. Your support will assist us in continuing our ministry to the students of West Chester University.

Qty

Description

Amount

Total

Ticket(s)

$75.00

---

per person

Other Donation Amount

---

Total: $0.00

Your Information

First Name: *

Last Name: *

Billing Address: *

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

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Affiliation Information

Alumni:

Check here if you are an alumnus/a of the University.

Class of:

If you checked Alumni above enter class year here.

Parent of:

Check here if you are a parent of a current student.

Student Name:

If you checked Parent above enter student's name here.

Class of:

If you checked Parent above enter student's class year here.

Current Student:

Check here if you are a current student.

Faculty/Staff:

Check here if you are a member of the Faculty/Staff.

Other:

Check here if other affliation and enter details in Comments or Questions box below.

Comments or Questions:

Do you have any comments or questions for us?

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *