Development & Donor Relations


Thank you for choosing to make a gift to UNB.

* I wish to:

* Total donation amount: $

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




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.

sample cheque image * 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:
* I would like the contributions to start on this date (Please choose a date from the calendar):
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I would like the following end date on my contributions (optional):
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* I would like the contributions to start on this date

Number of pay periods (leave blank for open ended recurring donation):
* I would like the contributions to start on this date:
- -
I would like the following end date on my contributions (optional):
-

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?

* Full name of other donor:


* I would like to direct my support to the following project:


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?
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?

I have included UNB in my will.

Would you like information about including UNB in your will?

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


* Email address:
* Employee name:
Donation type:
Donor Information
* Corporation Name


Contact person:

Title


* First Name


Middle Initial (optional)


* Last Name


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

* My Contact Information:

* Preferred Contact Email

(This email will be used for communications from UNB)

* Country


* Address Line 1


Address Line 2 (optional)


* City


* Province/State


* 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:


* Name on Card:


* Card Number:


* CVV Number: What's this?


* Expiration Date:


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.