IITMAANA Online Giving

Please use this form ONLY for Recurring Gifts using credit-card.

For all other forms of Gifts and for additional IITMAANA Giving information, please go to main IITMAANA Giving page at iitmadras.org/iitmaana/giving.

Note: You will eventually be taken to a secure third-party website ic3.com (owned by Cybersource) for entering credit-card/bank information.

Name

First Name: *

Last Name: *

IITM Class: *

IITM Dept.: *

Company: (can use stock ticker if available)

Contact

Email and mailing address will be used for sending acknowledgements and receipts.

Email: *

Phone: * (preferred format: nnn-nnn-nnnn, include international code for outside US)

Address: *

Address Line 2:

City: *

State: *

Zip Code: *

Country: *

Comment:

Use this field to provide additional contact info if your state/country are not listed above.

Contribution

Amount: * $ (amount in US dollars, min 25)

Frequency: *

Number of Payments: *

The number of payments is the total number of payments you wish to make, with each individual payment having the value specified in the "Amount" field. To modify your Recurring Giving plan at a future date, please follow the instructions on the IITMAANA Giving page at iitmadras.org.

Payment Mode: *

Credit Card

For large amounts, we recommend the "Bill Pay" or "Wire Transfer" options as they have a lower processing fee. More: IITMAANA Giving.

Project: *

Comment:

You can use the "Comment" field to further qualify your project designation (optional).

Company Matching: *

Yes

Yes but need help

Unsure

Does your company match gifts or volunteer time?

Consent

IITMAANA may use, with discretion, the contact and contribution information provided on this form towards (a) furthering its mission, (b) updating the alumni directory, and (c) collaborating with IIT Madras. By clicking "Donate" below, I agree to these terms and conditions.

Anonymous:

IITMAANA may chose to publish, with discretion, your name and the contribution.