You may make a secure online contribution to the Chilton Endowment. Just click here to make your gift using American Express, Discover, MasterCard or Visa. Or, you may print out, complete and mail or fax this form to the address below.
I/We wish to contribute to the Chilton Undergraduate Research Endowment * (click for note below)
Gift Intention Form
My/Our Total Gift Amount Will Be: $___________.
__ This is a corporate gift. Company name_______________________________________________________________________________
__ A check for the total amount of $_______ is enclosed.
__ I would like to charge my entire gift amount. Card Type:
__American Express __Discover __Mastercard __Visa
Name on Card:_____________________________Expiration Date:________
__ A check for $________ as my first payment is enclosed. A balance of $________ remains on my pledge and will be paid in equal annual installments over the next ___ (1-5) years.
__ I am enclosing a completed Payroll Deduction/Bank Draft Authorization Form. Each month for the next ___ (1-5) year(s) $_______($10 min.) will be deducted.
__ I am interested in learning about ways of supporting the Department of Plant Biology. Please call me.
(Please print or type.)
Phone_________________(Day) _________________(Eve.) FAX________________ Email_________________________ Website:________________________________
Employer (many match gifts!)______________________________________________
Please make checks payable to The North Carolina Agricultural
(you will receive an official receipt for your contribution,
and pledge reminders if you have chosen that option).
Send to: NC Agricultural Foundation, NC State University Box 7645, Raleigh, NC 27695.
Or, you may fax your forms to 919-515-5274.
If you have any questions or require additional information, please call
Chris Cammarene-Wessel at 919-515-7678 (firstname.lastname@example.org).
Chilton passed away suddenly in
August 2004. His family requested that gifts
in remembrance of Dr. Chilton may be made to this endowment. Our sincere thanks go out to
the Chilton family, his friends, colleagues and students.
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Last modified: October 2006