Development & Donor Relations

Thank you for choosing to make a gift to UNB.

* I wish to:
make a one-time gift.

* Total donation amount: $

make a contribution toward my existing pledge.

* Pledge ID:
* Payment amount: $
* Email:

make multiple contributions toward a total gift over time.

Credit Card

Pre-Authorized Bank Withdrawals
Payroll Deduction (UNB Employees only)

Pre-Authorized contributions may be made on a monthly basis on the 1st or 15th of each month. By providing the banking information below, you are authorizing us to set up the pre-authorization for the purpose of this donation only. Please allow 10 business days for set up and processing of the first contribution.

* Transit no.:

* Institution no.:

* Account no.:

Payroll deductions may be made on a bi-weekly basis by UNB employees only. There are 26 pay periods in a calendar year.

* Recurring amount: $

* I would like my contributions to recur: Bi-weekly Monthly Quarterly Semi-annually Annually

* I would like the contributions to start on this date (Please choose a date from the calendar):

I would like the following end date on my contributions (optional):

* I would like the contributions to start on this date
2023-06-09 2023-06-23 2023-07-07 2023-07-21 2023-08-04 2023-08-18 2023-09-01 2023-09-15 2023-09-29 2023-10-13 2023-10-27 2023-11-10 2023-11-24
Number of pay periods (leave blank for open ended recurring donation):

* I would like the contributions to start on this date:
  2023 2024 2025 2026 2027 2028 2029 -   01 02 03 04 05 06 07 08 09 10 11 12 -   01 15
I would like the following end date on my contributions (optional):
  2023 2024 2025 2026 2027 2028 2029 -   01 02 03 04 05 06 07 08 09 10 11 12

Total Donation Amount: $

* Name of Donor:


If you have recently moved, please update contact information (i.e. address, phone number) below:

* Would you like this to be considered a joint gift? Yes No

* Full name of other donor:

* I would like to direct my support to the following project:
- Select a Project - Opportunities Fund University Wide (2012I01) Opportunities Fund Fredericton Campus (2012I02) Opportunities Fund Saint John Campus (2012I03) Opportunities Fund Faculty (Specify faculty below) Scholarships University Wide (2010S01) Scholarships Fredericton Campus (2010S02) Scholarships Saint John Campus (2010U02) Libraries University Wide (2009L03) Libraries Fredericton Campus (2009L04) Libraries Saint John Campus (2009U14) Other (Provide additional details below)

Here are additional details to help UNB better understand what I want (optional):

I am making this donation in memory of (optional):

* Would you like notification sent to the family? Yes No

Please provide name and address of family member to be notified
* Name:

* Address:

* Do you agree to allow UNB to publish your name in the annual Donor Honour Roll? Yes No

I have included UNB in my will. Yes No

Would you like information about including UNB in your will? Yes No

* UNB/Student/Alumni ID Number (if known)

I don't know my UNB number

I don't have a UNB number - I have not studied or worked at UNB

* Email address:
* Employee name:

Donation type: Individual Corporate

Donor Information

* Corporation Name

Contact person:

Title
  Mr. Mrs. Miss Ms. Dr.

* First Name


Middle Initial (optional)


* Last Name


I declare that (name) is the true donor of this gift. (This name will be used for tax receipting purposes)

CRA (Canada Revenue Agency) defines the true donor as the individual or organization making the donation to the charity. It normally will be the name on the credit card, but not always. For example, a corporation (the true donor) may make a gift by credit card but the Name on Card would always be the name of an individual.

* My Contact Information:

* Preferred Contact Email

(This email will be used for communications from UNB)

* Country
CanadaUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia HercegovinaBotswanaBouvet IslandBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, DPRKKorea, Republic ofKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldova, Republic ofMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbard/Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaViet NamVirgin Islands (British)Virgin Islands (US)Wallis and Futuna IslandsWestern SaharaYemen, Republic ofYugoslaviaZambiaZimbabwe

* Address Line 1


Address Line 2 (optional)


* City


* Province/State
Outside U.S./Canada AB Alberta BC British Columbia MB Manitoba NB New Brunswick NL Newfoundland/Labrador NS Nova Scotia NT Northwest Territories NU Nunavut ON Ontario PE Prince Edward Island QC Quebec SK Saskatchewan YT Yukon AK Alaska AL Alabama AR Arkansas AS American Samoa AZ Arizona CA California CO Colorado CT Connecticut DC District of Columbia DE Delaware FL Florida FM Micronesia GA Georgia GU Guam HI Hawaii IA Iowa ID Idaho IL Illinois IN Indiana KS Kansas KY Kentucky LA Louisiana MA Massachusetts MD Maryland ME Maine MI Michigan MN Minnesota MO Missouri MP Northern Marianas MS Mississippi MT Montana NC North Carolina ND North Dakota NE Nebraska NH New Hampshire NJ New Jersey NM New Mexico NV Nevada NY New York OH Ohio OK Oklahoma OR Oregon PA Pennsylvania PR Puerto Rico RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VA Virginia VI Virgin Islands VT Vermont WA Washington WI Wisconsin WV West Virginia WY Wyoming

* Postal/ZIP Code


* Phone

* Your tax receipt will be sent to the email address already provided. Please change below if you want the receipt to go to a different email address:

* Card Type:
VISA MasterCard AMEX

* Name on Card:


* Card Number:


* CVV Number: What's this?


* Expiration Date:
Month 010203040506070809101112 Year 20232024202520262027202820292030203120322033

PRIVACY STATEMENT:
UNB and Development and Donor Relations are committed to protecting personal information. Your personal information is being collected for the fundraising purposes set out in the form and will only be accessed by the administrators. For more information on privacy at UNB, please consult UNB's Policy for the Protection of Personal Information & Privacy and the University Secretariat, University of New Brunswick, PO Box 4400, Fredericton, NB, E3B 5A3 www.unb.ca/secretariat (506) 453-4613.