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I pledge the amount shown below as my contribution to The Graduating Class Gift campaign. The balance of my general deposit, at the time of my graduation, will be my gift. If my general deposit was paid by a sponsoring agency, I understand the obligation to refund the general deposit to the agency will cancel this pledge.

I WISH TO PLEDGE (Check One)

_____ The balance of my general deposit.

_____ $_____ in addition to my general deposit.

_____ $_____ of my general deposit.

Student Name __________________________ Student Number ____________________

Graduation Semester _____________________ Major ____________________________

Student Signature _______________________ Date ______________________________

PXCJF

Please Print and Mail To:

Office Of The University Development
The Pennsylvania State University
One Old Main
108 Business Services Building
Univesity Park, PA 16802-9976