Your gift is the difference! Thank you for supporting Keene State College and our students.

If you need assistance with this form, please contact advancement@keene.edu or 603-358-2375.

Gift Information:

Gift amount - numbers only, please do not enter a dollar sign (e.g. 100.00):
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Where would you like to designate your gift?
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Please select where you would like to designate your gift:

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Please select where you would like to designate your gift:

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Please select where you would like to designate your gift:

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Please type the specific, program, major, endowment, department, or scholarship, that you would like your gift to benefit:

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Would you like your gift to remain anonymous?
Would you like your spouse/partner to receive gift credit/recognition?
Spouse/partner prefix:
Spouse/partner first name:
Spouse/partner middle name:
Spouse/partner last name:
Spouse/partner suffix:
Spouse/partner email:
Spouse/partner phone number (xxx-xxx-xxxx):
Type of phone provided:
Spouse/partner affiliation to KSC:
Class of:
Maiden Name:
Student's Name:
Student's Anticipated Graduation Year:
Your Anticipated Graduation Year:
Student ID Number:
How is this person related to you?
Please specify:
Does your spouse/partner have the same address as you?
Spouse/partner address 1:
Spouse/partner address 2:
Spouse/partner city:
Spouse/partner state:
Spouse/partner zip code:
Is your gift in honor of a person? Please provide their full name:
Is your gift in memory of a person? Please provide their full name:

Donor Information:

Prefix:
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First Name:
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Middle Name:
Last Name:
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Suffix:
Address 1:
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Address 2:
City:
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State:
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Zip code:
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Email:
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Phone Number (xxx-xxx-xxxx):
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Type of phone number provided:
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Affiliation (please choose the best option):
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Class of:
Maiden Name:
Student's Full Name:
Student's Anticipated Graduation Year:
Your Anticipated Graduation Year:
Student ID Number:
Please include any additional comments regarding your donation:
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