PBK Alumni of Greater Houston - Scholarship Donation Form

PBK Houston Scholarship Donation Form

* Mandatory fields

Full Name

Prefix

*First name

Middle Name

*Last name

Suffix

Salutation / Nickname

Organization

*Street or mailing address

Address line 2

*City

*State

*Zip

*Email

*Phone

Zip Code

We would like to sponsor a scholarship at the following level:

Endowed Scholarship (Up to 10 guests) $50,000

Gold Key Scholarship (Up to 10 guests) $10,000

Silver Key Scholarship (Up to 10 guests) $7,500

Bronze Key Scholarship (Up to 8 guests) $4,000

Key Underwriter Ticket—$1,000 each

Underwriter Ticket—$500 each

Individual Ticket—$250 each

I wish to donate ($USD)

*Total Amount Due ($USD)

If donating $4,000 or more, please designate the name of scholarship:

*Donor name for printed materials:

Contact name (if different):

My table will include the following attendees (please list names):

*Payment frequency

One-time

Monthly

Quarterly

Semi-annually

Annually

Additional comments or notes

PHI BETA KAPPA
ALUMNI ASSOCIATION OF GREATER HOUSTON

P.O. Box 25283
Houston, Texas 77265

(713) 553-0615 | info@PBKHouston.org