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Club Mem Support
Welcome new Wolverine students and parents! Thank you for supporting us through Club Mem!
Your Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Mailing Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Student's Info
Student Name
*
First Name
Last Name
Expected graduation year of this freshman or transfer student(s)
*
Umich Email
Verify Email
Cell Phone
Campus Address (if known)
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Add another freshman or transfer student?
Yes
Student Name #2
First Name
Last Name
Expected graduation year of this incoming or freshman student(s) #2
Cell Phone #2
Umich Email #2
Verify Email
Campus Address (we will need this to deliver their goodies!) #2
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Donation Information
Donation
*
$720
-
Club Mem
$1,800
-
Chai Society
$0
-
Pledge Now, Pay Later (Stacy will contact you to coordinate)
$
Donate Anonymously?
Note: In choosing Yes, your name will NOT appear in our Annual Report's Honor Roll of Supporters.
Yes
Will this be a Tribute gift?
*
No
Yes
I am making this gift:
In honor of
In memory of
Please provide the name and address for tribute and any additional comments you would like to include. (Tributes without addresses listed cannot be mailed)
How should your name be listed on Michigan Hillel's Newsletter and Website?
example: John & Jane Doe
Add 3% to my total amount to help cover the payment processing fees