University of Manitoba - Donation Form

Donation Amount

Amount:

Direct my gift to:

Dr. Laliberte and Dr. Bulley Scholarship

Gift Information

Type of gift:

One-time gift

Monthly gift

Corporate:

This donation is on behalf of a company

Anonymous:

I prefer to make this donation anonymously

Comments:

I have included the U of M in my will:

Alumni:

Card Message (max. 250 characters):

Friend:

Staff/Faculty/Retiree:

Student:

Please send me Planned Giving Information:

Personal Information

Title:

First name:

Last name:

Country:

Address lines:

City:

Province:

Postal Code:

Phone:

Email:

Payment Information

Name on Credit Card

Credit Card Number:

Card Type:

Card Expiry:

Card Security Code:

Additional Security

This is a security measure to help prevent fraud.

Tribute Information

Type:

First name:

Last name:

Mail a card on my behalf

QUICK LINKS

Donor Relations at UM Facts and Figures Our Strategic Vision

ABOUT

University of Manitoba About Us Privacy and Terms of Use

Facebook Instagram Twitter YouTube LinkedIn

Donor Relations
100-137 Innovation Drive, University of Manitoba R3T 6B6
Phone: 204.474.9195
Toll-free: 1-800-330-8066
Fax: 204-474-7635
giving@umanitoba.ca
Charitable Registration Number: 11926-0669-RR0001

QUICK LINKS

ABOUT

FOLLOW US