Home > Foundation > Make an Impact > Annual Pledge

Pledge Form

If you would like to make a pledge in annual installments to the MSUM Foundation, please complete the form below:

*indicates required field

Total pledge (amount):

Fund designation (department/area/fund):

Number of annual installments: 1 2 3 4 5

Date of first installment mm/dd/yyyy (you will be sent a reminder as installment date nears):

First Name:*

Last Name:*

Email address:*

Cell phone number:

Address:*

City:*

State:*

Zip Code:*

Country:

Additional comments or instructions:

If you have questions please contact alumni@mnstate.edu.