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Governor's Scholar Program Donation Form
This form takes 2-3 minutes to complete (120-180 seconds)!
Which Fund would you like to contribute towards?
*
These funds are ways we categorize our donations. Pick one you would like to support.
Aris' Fund for the Future
General Fund
Hal Smith Scholar Fund
Who is donating?
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Are you making a donation on your behalf or for an organization?
Individual
Organization
Are you an Alumni?
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Alumni are those that completed the summer program.
select one
Yes
No
Are you a relative to an Alumni?
*
Alumni are those that completed the summer program.
select one
Spouse
Parent/Guardian
Grandparent
Other Relative
None of the above
Relation to Alumni
Optional: This helps our team identify you in our records
Are you a board member to GSP/Foundation?
*
select one
Past Board Member
Current Board Member
None of the Above
Relation to Program?
*
Please help us determine your relation to the program (Ex: High School Counselor, Friend of __ Alumni/Parent, etc...)
Type of Organization?
*
Corporation
Foundation
Amount
*
$1,000
$500
$250
$100
$50
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Continue donating until
(mm/dd/yyyy)
Would you like for this donation to be anonymous?
*
If yes, your donation will not be publicly available in our promotional material.
select one
Yes Anonymous
Not Anonymous
This donation will be matched by my employer
*
This is for us to ensure your corporation's matching gift is recorded properly.
select one
Yes
No
Name of business matching your donation
*
Please type out acronyms.
Would you like a physical copy mailed to you, in addition to your automatic emailed tax receipt?
*
An automatic email tax receipt will be sent to the provided email. You may request a physical copy here.
select one
Yes
No
Contact Information
Your Organization Name
Only required for Organization donors. Please type out acronyms. Optional for individual donors.
Prefix
*
How are you to be addressed? (Mr, Ms, Mrs, etc...)
Your Name
*
First Name
Last Name
Suffix
Optional: Please add any relevant suffixes/post nominal letters. (Ex: Jr, II, III, PhD, CPA, Etc.)
Your Middle Name/Initial
Optional: This helps our team identify you in our records
Alumni-Relative's Name (Ex: your child, spouse, etc). Please provide maiden name during their GSP summer.
Prefix
First Name
Last Name
Suffix
Alumni-Relative's Campus
Optional: This is the campus your alumni-relative completed their GSP summer.
select one
Bellarmine
Centre
EKU
Morehead
Murray
NKU
UK
WKU
Alumni-Relative's Year
Optional: This is the year they completed the GSP program. (Ex: 2003)
Your Scholar Last Name (Alumni Maiden Name during your GSP summer)
*
This helps our team identify you in our records
Your Alumni Campus
*
This is the campus where you completed the summer program.
select one
Bellarmine
Centre
EKU
Morehead
Murray
NKU
UK
WKU
Your Alumni Year
*
This is the year you completed the summer program. (Ex: 2003)
Email
*
Only used for donation troubleshooting and an automatic tax receipt. If you don't receive this email please check your spam folder.
Verify Email
*
Phone
*
Only to be used for donation troubleshooting.
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Did one of the following prompt you to donate?
*
Select all that apply.
Mail
Email
Social Media
Word of mouth
Other
Any comments, questions, or concerns?
We will reach out to you about any question you may have.
Add 3% to my total amount to help cover the payment processing fees
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