By submitting this online form you are making a pledge to AUA. For assistance, please contact our U.S. Office at: Phone: +1(510) 987-9452, e-mail: [email protected] Your InformationFirst Name*Last Name*Email* Phone*Home AddressStreet*City*State*Zip*Country*Sponsorship LevelsGift Amount* Benefactor of Education - $25,000 USD Patron of Education - $10,000 USD Protector of Education - $5,000 USD Sponsor of Education - $3,000 USD Friend of Education - $1,500 USD Individual Ticket - $300 USD Choose Where to Direct Your Gift*Select oneTo Support the Undergraduate ProgramPlease direct my gift where it is most urgently neededPayment DetailsCredit Card Type*Master CardVisaAmerican ExpressDinners ClubDiscoverCredit Card Number*Expiration Date (MM/YY)*Security Code*(The CVV security code is the three digit code located on the back of all cards except American Express, which is a four digit code located on the front to the upper right of the number.)Billing Information Is the same as Home address OtherStreet*City*State/ProvinceZip Code*Country*CaptchaΔ
