Online Giving Form

Thank you for your gift in support of Lee Academy. Whether for the Annual Fund, the L.A. Capital Campaign, or one of our scholarships to benefit graduating seniors, your donation makes a deep and lasing impact on the lives of our students.

Your generosity is deeply appreciated.

NOTE: All gifts are made through a secure server and are tax deductible to the fullest extent of the law. Once your online donation has been made, you will receive an email confirmation as well as a gift receipt through the mail for tax purposes.

Gift Information

Please choose one:

One-time gift
Payment on an existing pledge
Divide my payment in $ /month for months for a total gift of $

Family of Funds Designation (Please choose one or more of the following):

		$
		$
		$
	GIFT TOTAL:	$

Special Instructions (in memory of, in honor of, scholarship designation, etc.):

YOUR INFORMATION

Fields marked in yellow are required.

First Name		Last Name
Maiden Name		Grad Year
Address 1		Address 2
City/Town		State
Zip		Country
Phone		E-mail
Employer		Title
Work Phone		Date of Birth

SPOUSE/PARTNER INFORMATION

First Name
Last Name
Maiden Name
Grad Year

ALUMNI ASSOCIATION DUES

Yes, please include my dues to support the work of my fellow alumni through the LA Alumni Association

TOTAL GIFT AND DUES: $

MATCHING GIFT INFORMATION

Yes, I work for a Matching Gift Comany

Company Name:

Please send your matching gift form to:

26 Winn Road
Lee, ME 04455

PAYMENT INFORMATION

Type of Credit Card
Name on Credit Card
Credit Card Number
Credit Card Expiration Date
	TOTAL CREDIT CARD CHARGE: $

Please direct any questions regarding your gift or this on line giving form to:
Office of Institutional Advancement
Lee Academy
26 Winn Road
Lee, ME 04455
(207) 738-2252
(888) 433-3257
or email