Hamptonians for Hampton

Please use the form below if you would like to schedule a monthly gift using a credit card. If you would prefer to use a check, please use our mail-in form (click here).

To make a one-time gift, please visit http://donateto.hamptonu.edu.

Fields marked with * are required.

Title

Military Title

First Name*

Last Name*

Maiden Name (If Applicable)

Address * (This address must match the bank card billing address.)

City*

State:*

Zip Code*

Country*

HU Class Yr.

Phone Number*

Email*

If your employer is matching your contribution:

Employer

Occupation

Comments or Special Instructions

Donor Status*

Campaign*

Monthly Amount* $

Number of
Monthly Installments*

Start Date
(Please Use mm/dd/yyyy)*

Credit Card Number:*

Expiration Date:*

CVV (?)*

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Set Up a Recurring Gift