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Donor Name	* Required
First Name*:
Middle Initial:
Last Name*:
Bradley Alum:	Yes

Address & Contact Information
Street Address*:
City*:
State*:
Zip*:
Phone*:	( ) -
Email*:
	An email confirmation will be sent to this address once you submit your donation. To ensure proper delivery of our emails, please add advancement@bradley.edu to your address book.

Gift Information
Amount*:	$
Designation*:
	If other, please specify:


	To make multiple designations, please select "Other" and then explain.

Matching Gift
My employer matches gifts to higher education*:
	Yes No
Employer Name:
Street Address:
City:
State:
Zip:
Phone:	( ) -

(Note: Please ask your Human Resources Department for the appropriate form and return it to the Advancement Office at 1501 West Bradley Avenue, Peoria, IL 61625.)

Donor Name