Northern Illinois University Printable Gift Form   Please print this gift form and mail it along with your donation to the address specified at the bottom of this page.   Name: ______________________________________________________________  First  Middle Last Maiden Mailing Address: __________________________________________________________   City ________________________ State _____________ Zip Code _________________   Telephone ___________________ E-mail address _______________________________   Joint (husband and wife) gift? (circle one)   Yes  No  If yes, spouse's name: __________________ I am a:   Alumnus(a) grad year _________  NIU Parent Student's Name: ________________   Faculty/Staff Department: ___________________ Student   Friend    Other Gift Information   A check for my gift of $______ is enclosed. (Checks should be made payable to the Northern Illinois University Foundation.)   Please charge my gift of $_______ to the following credit card: Circle one:   VISA  MasterCard Discover American Express Account Number:  _____________________________  Expiration Date:  _____________________________  Signature:  _____________________________ Gift Designation   Please use my gift to provide funding for the university's highest priorities. Please restrict my gift to be used by the following college: _____________________. Please restrict my gift to be used by the following department: __________________. Please restrict my gift to be used by the following area or program: ______________.   If your gift can be matched by your employer's matching gift program, please check with your personnel or benefits office for details and the proper form to enclose. Please return this form, along with your contribution to: Northern Illinois University Foundation 1425 W. Lincoln Highway DeKalb, IL 60115