The
University of Texas at Dallas School of Arts & Humanities
Tiers of Friendship
* Print this page to fax or mail * |
| $ |
Student |
under $100 |
| $ |
Friend |
$100-$249 |
| $ |
Lover |
$250-$499 |
| $ |
Connoisseur |
$500-$999 |
| $ |
Dean's Circle |
$1000+ |
| $ |
My employer will match my gift.
Employer: |
| $ |
Total |
______Yes |
______No |
I would like to be
on your mailing list. (To be on our mailing list without joining
the Tiers of Friendship, please fill out the News & Events list here.) |
Name(s) as you would like them listed on the programs:
|
| Address |
| City |
State |
Zip |
| Home Phone (
)
Work Phone ( ) |
| Email address |
_____Check enclosed
payable to UTD
(mail only) |
_____VISA |
_____MASTERCARD |
_____ Discover |
| Name on Card |
| Account Number |
Expiration Date |
| Authorized Signature |
Today's Date |