Your Gift to The Dartmouth Institute

Thank you for your gift.

If this is a gift in memory of or in honor of someone, please complete the Memorial and Honorary Gifts section at the bottom of this form.

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Donation Information
Amount:	Gift of $ 1,000.00 Gift of $ 500.00 Gift of $ 250.00 Gift of $ 100.00 Gift of $ 50.00 Other $     *
Designation:	The Alumni Fund for the Dartmouth Institute The Dartmouth Institute Scholarship Fund
Additional Information
Frequency:	Weekly Monthly Quarterly Annually On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
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Billing Information
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Payment Information
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Matching Gifts
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Tribute Information
Type:	in memory of in honor of	*
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For questions, please contact:

Robert Holley
Director of Advancement, The Dartmouth Institute
Sr. Associate Director for Development, Geisel School
(603) 653-0733