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  AMICAE DONATION PAGE

DONOR INFORMATION -  Please enter your personal information:

* First Name:
* Last Name:
* Email:
* Phone:
* Address:
* State:
* Zip Code: -

 

Occassionally, the Centennial Commission will publish donor reports. We will also list donors on the Centennial website (updated quarterly). Please answer the following question - Do you wish to remain anonymous rather than appearing on these external reports and listings? We will assume your answer is "No" if the field is left unselected.

* I wish to remain anonymous on all reports. No
Yes

 

DONATION AMOUNT - Please enter the donation amount:

* Donation Amount:

Please list your name exactly as you would like it to appear on a recognition / award certificate.

* Full Name
 

 

 

DONATION ALLOCATION

PLEASE READ THE INFORMATION BELOW BEFORE YOU SUBMIT YOUR DONATION

You MUST allocate your donation to ONLY ONE  Section.  Please review the Section Descriptions below and then scroll down on the form to the matching Section and indicate how you wish to apply your donation. 
Please only enter your selection on ONE section only.  The donations CANNOT be split across two sections.


Section 1 -  Regional Donation - Please choose this section if you would like your Region to get credit for you donation.

Section 2 - State Donation - Please choose this section if you would like your State to get credit for you donation.

Section 3 - Local Auxiliary/Sponsoring Chapter -  Please choose this section if you would like your Local Auxiliary/Sponsoring Chapter to get credit for you donation.

Section 4 - Individual Donation - Please choose this section if wish to submit a donation as an individual Amicae and do NOT wish to have it allocated to a Region, State, or Local Auxiliary.

SECTION 1 - REGIONAL DONATION ONLY
 

If you would like your Region to get credit for your donation please select your Region from the list below:

Regional Amicae of:

SECTION 2 - STATE DONATION ONLY

If you would like your State to get credit for your donation please select your State from the list below:

State Amicae of:

SECTION 3 - LOCAL AUXILIARY/SPONSORING CHAPTER ONLY

If you would like your local auxiliary to get credit for your donation please select your sponsoring Zeta Phi Beta chapter from the list below:

Atlantic Region Sponsoring Chapter
Eastern Region Sponsoring Chapter
Great Lakes Region Sponsoring Chapter
Midwestern Region Sponsoring Chapter
Pacific Region Sponsoring Chapter
South Central Region Sponsoring Chapter
Southeastern Region Sponsoring Chapter
Southern Regional Sponsoring Chapter

SECTION 4 - INDIVIDUAL DONATION ONLY

If you would like to submit a donation as an individual, and you do NOT wish to have it allocated to a Region, State, or Local Auxiliary / Sponsoring Chapter Only please select Individual Contribution.

Individual Contribution I wish to submit an individual donation and do NOT wish to have it allocated to a Region, State, or Local Auxiliary

 

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