LoyolaLoyal - Loyola University

Loyola Loyal Day Gift and Pledge Form

Amount:

$

*

Designation:

Other

*

Additional Information

Type of gift:

One-time gift

Recurring gift

Comments:

Who inspired you to make this gift to Loyola?:

Contact Information

Title:

First name:

*

Last name:

*

Country:

*

Address lines:

*

City:

*

State:

*

ZIP:

*

Phone:

Email:

*

Payment Information

Payment Method:

Credit Card

Pledge

Cardholder's Name:

*

Credit Card Number:

*

Card Type:

*

Card Expiration:

/

*

Card Security Code:

help

*

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