THE FR. TOM HALKOVIC STUDENT LEADERSHIP SCHOLARSHIP

THE FR. TOM HALKOVIC STUDENT LEADERSHIP SCHOLARSHIP NAME:

CLASS:

SPOUSE NAME:

SPOUSE CLASS:

RELATIONSHIP TO STONEHILL:

 ALUMNI

 PARENT

 FRIEND

 FACULTY/STAFF

 STUDENT

ADDRESS:

TELEPHONE:

EMAIL:

PLEASE ACCEPT MY/OUR GIFT OF:  $1,000

 $500

 $250

 $100

 $50

 $25

 OTHER: _____________________________________________________________  PLEASE CHARGE MY/OUR GIFT

 MY/OUR GIFT IS ENCLOSED. (PLEASE MAKE CHECKS PAYABLE TO STONEHILL COLLEGE.)

PAYMENT METHOD: CREDIT CARD:

 AMERICAN EXPRESS

 MASTERCARD

 VISA

CARD NUMBER: ________________________________________________________________________________________ EXPIRATION DATE: _______________________________ SECURITY CODE: ______________________________________ NAME ON CARD: _______________________________________________________________________________________ SIGNATURE: ___________________________________________________________________________________________

MY/OUR GIFT WILL BE MATCHED BY: _________________________________________________ (COMPANY NAME) PLEASE FIND THE  FORM ENCLOSED OR  FORM WILL BE FORWARDED. GIFT DESIGNATION:  THE FR. TOM HALKOVIC STUDENT LEADERSHIP SCHOLARSHIP

LEARN MORE ABOUT THE FR. TOM HALKOVIC STUDENT LEADERSHIP SCHOLARSHIP www.stonehill.edu/giving/halkovic-scholarship/ THANK YOU FOR YOUR SUPPORT Please mail completed form to: Office of Development | Stonehill College | 320 Washington Street Easton, MA 02357-6242 To make your gift online, visit www.stonehill.edu/giving.