Southern University System Foundation Donor Profile
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The Southern University System Foundation is in the process of updating donor records,

and your help is needed. Please complete the form and submit it to the Division of

Advancement Services.

 

* Required Fields

 

Mr. Mrs. Ms.
* Last Name		* First Name	Maiden Name
01 02 03 04 05 06 07 08 08 10 11 12     01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
* Birth Date			* Telephone
			Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
* Address		* City                * Zip (+4 digits)	* State
Campus (Check all that apply)
SUAGREC		SULAB	SUSLA
SUNO		SUBR	SULC
Major		Degree Granted	Semester & Year Graduate
Certification		* Email Address	Office Telephone (Area Code)
Place of Employment		Position/Title	Cell/Pager Number
I work for a matching gift company  Yes   No			If so,

 

	01 02 03 04 05 06 07 08 08 10 11 12     01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007	Single Married Widow Divorced Separated
Spouse's Name	Anniversary Date	Marital  Status
Spouse's College and Degree
Spouse's Position and Place of Employment

 

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