Make a Gift Information for online Gift Gift Amount: Your card will be charged this amount immediately. ---- $25 $50 $100 $250 $500 $1,000 $Other Please designate my contribution to Please select Chester Pierce Baseball Stadium Annual Fund-Where Needed Most Annual Fund-Beat the Heat Fund for McAuley Hall Annual Fund-Student iPads Annual Fund-Scholarships Annual Fund-Campus Ministry Annual Fund-Middle School Obstacle Course Annual Fund-Burke Hall Science Lab Capital Campaign Pledge Payment Would you like to make this gift recurring? Choose an option below. Your card will be charged for the above amount based on your selection, starting today. To stop recurring payments, please contact Amanda Livingston, 478-751-3240, ext. 192. Monthly Quarterly (Jan, Apr, Jul, Oct) Quarterly (Mar, Jun, Sep, Dec) This is a one-time gift. If giving in memory of or in honor of loved ones, please list names Your Information First Name Maiden Name Last Name Class Year Address City State Zip Code Country Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic Cook Islands Costa Rica Côte d'Ivoire (Ivory Coast) Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (north) Korea (south) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis and Futuna Islands Western Sahara Yemen Zaire Zambia Zimbabwe Primary Phone Work Phone Other Phone Preferred E-mail Double your Dollars! Many companies match contributions to independent schools from employees or employees' spouses. Contact your personnel office for a matching gift form and help Mount de Sales Academy receive double or even triple the amount of your gift. Amount of Match $ Name of your/spouse's corporation Please mail your company's matching gift form to: Amanda Livingston Mount de Sales Academy 851 Orange Street Macon, GA 31201 Relationship to School Check all that apply Alumnus Parent Trustee Former Parent Grandparent Friend Faculty / Staff News You'd Like To Share News you'd like to share with us (about you or your family) Payment Information Name on Card Card Type ---- MasterCard Visa American Express Discover Number Number Expiration MM 1 2 3 4 5 6 7 8 9 10 11 12 / YYYY 20162017201820192020202120222023202420252026 CVV A tax receipt and acknowledgement will be sent directly to you from the school. Thank You Please leave this field empty Please leave this field empty