Make a Gift Now


* Required Fields

Title(s):
* First Name:
Middle Initial:
* Last Name:
Suffix:
* Address:
* City:
* State:
* Zip:
Home Phone:
Work Phone:
* Email address:

Please select if you wish your donation to remain anonymous. If no selection is made, all gift amounts will be kept confidential unless express permission is granted by the donor(s).

Medical Center Alumni?

If yes, what school?

Year of Graduation?

Are you a Medical Center Employee?

I will support the Medical Center with a gift of $ .


Is this gift a "one time" donation?

If this gift is not a "one time" donation, please complete the information below.


I am making a a gift of $   every     ,

for a total gift of $ .


I am making a recurring gift of $ , given every

I wish my gift to benefit:
(Note: The Donate Now button will not appear until a beneficiary is selected)

 


If you wish your gift to be split among more than one recipient (i.e., school, library, hospital, etc.), please enter the information below or contact the Development office at (601) 984-2300.

 


Method of payment:

Visa
Mastercard

American Express

Discover

* First Name as it appears on card statement:
* Last Name as it appears on card statement:
* Address as it appears on card statement:
* City as it appears on card statement: * State as it appears on card statement:
* Zip code as it appears on card statement
Card Number: Security Code:
Exp. Date: (MMYY)

(Note: The Donate Now button will not appear until a beneficiary is selected)