Contribution Amount $ 25.00 $ 50.00 $ 100.00 $ 250.00 $ 500.00 $ 1,000.00 Other Amount Other Amount $ Total Amount I want to contribute this amount every month(s) year(s) for installments Your recurring contribution will be processed automatically. You can specify the number of installments, or you can leave the number of installments blank if you want to make an open-ended commitment. In either case, you can choose to cancel at any time. You will receive an email receipt for each recurring contribution. Contact Info Prefix * Mrs. Ms. Mr. Dr. Mme. First Name * Last Name * Suffix Jr. Sr. II III IV V VI VII Email (Primary) * Address * Additional Address 1 (Primary) City * State * - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip * Country (Primary) * - select Country (Primary) - United States Phone * Connection with UHS (check all that apply) * Alum (graduated from UHS) Attended (did not graduate from UHS) Current UHS Student Current/Former UHS Faculty/Staff Friend of UHS Parent of Current UHS Student Parent of Prospective UHS Student Parent of UHS Alum Prospective UHS Student UHS Class Year - select UHS Class Year - 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 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 If you went by a different first name, last name or both while at UHS UHS First Name UHS Last Name Review your contribution
