Thank you for participating in the Faculty, Staff, and Retirees Campaign at the University of Manitoba!

Faculty and Staff interested in donating through payroll deduction can do so by completing the online form (Payroll Deduction Form).

Donation Amount
Amount:	$     *
Direct my gift to:	Area of Greatest Need Student Food Bank Rady Family Centre Gift University of Manitoba Student Bursaries Isbister Undergraduate Scholarships National Centre for Truth and Reconciliation Enter a fund name
Enter a fund name	*
Gift Information
Type of gift:	One-time gift Monthly gift
Frequency:	Weekly Monthly Quarterly Annually On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
Corporate:	This donation is on behalf of a company
Anonymous:	I prefer to make this donation anonymously
Comments:
Alumni:	Yes No
Card Message (max. 250 characters):
Friend:	Yes No
Staff/Faculty/Retiree:	Yes No
Student:	Yes No
Personal Information
Title:	Capt. Dr. Fr. Judge Major Master Miss Mlle. Mme. Mr. Mrs. Ms. Prof. Rev. Sr. The Honourable
First name:		*
Last name:		*
Country:	Canada United States Australia Austria Belgium Brazil Cayman Islands China Denmark England France Germany HONG KONG India Ireland, Republic of (EIRE) Italy Japan Lesotho Malaysia Mauritius Netherlands New Zealand Nigeria Norway Poland Russian Federation Saudi Arabia Scotland Singapore Swaziland Switzerland United Kingdom	*
Address lines:		*
City:		*
Province:	<Please Select> MB AB BC NB NL NT NS NU ON PE QC SK YT -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS CZ FM GU MH MP PW PR VI AA AE AP N/A	*
Postal Code:		*
Phone:
Email:		*
Payment Information
Name on Credit Card		*
Credit Card Number:		*
Card Type:	Visa American Express MasterCard	*
Card Expiry:	01 02 03 04 05 06 07 08 09 10 11 12  / 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043	*
Card Security Code:		*
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