ENDOWMENT PLEDGE FORM

Yes, I would like to become a member of the UCD Symphony Endowment

Name:                                                                                      Total Contribution: ________      [   ] New       [   ] Additional

Address:

Phone:

e-mail:

Date:

Notes:

PAYMENT SCHEDULE

Amount enclosed:

By 31 December 2005:

By 31 December 2006:

By 31 December 2007:

Gift to be matched by my employer:

Please make checks payable to UC Davis Foundation / UCD Symphony Endowment, and send them with this form to:

UCD Symphony Endowment
Department of Music
University of California, Davis
One Shields Avenue
Davis, CA, 95616

Contributions are tax-deductible. Gifts are eligible to be matched by corporations with matching gift programs. Individual donors will be listed alphabetically. Total contributions of $1,000 or more and $2,500 or more will be identified by asterisks. If you prefer that your contribution not be so identified, please check here: [    ].

The UC DAVIS FOUNDATION is a California non-profit, public benefit corporation organized for the purpose of encouraging voluntary private support for the benefit of UC Davis and is recognized under federal and state tax laws as a qualified donee for tax-deductible charitable contributions. Responsibility for governance of the Foundation, including investments, is vested in its Board of Trustees, which is composed of community leaders and senior campus administrators.

PRIVACY NOTICE

According to the 1977 California Practices Act, any donor information provided is voluntary and will not be disseminated to others except if required by law. Inquiries should be forwarded to the Director of Advancement Services, University Relations, University of California, One Shields Avenue, Davis, CA 95616.

DONOR'S CONSENT

UC Davis is grateful for the support it receives from friends and alumni. One of the ways our appreciation is expressed is through listing the names of donors in relevant publications. Should you wish to exclude your name from donor lists, please notify us if you have not already done so.

GIFT FEE POLICY

UC Davis utilizes a fraction of gift and/or short-term investment income to support the cost of raising and administering funds.

The University of California does not discriminate in any of its policies, procedures or practices, and is an affirmative action/equal opportunity employer.