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Tony Fox, Program Officer
(505) 753-8890 ext: 16
tony@lanlfoundation.org

Please help us invest in the future by making the dream to attend college a reality for the talented and motivated students of Northern New Mexico.


Los Alamos Employees’ Scholarship Fund
Campaign 2014 Pledge Form

Please fill out your personal information on this online pledge form and indicate giving and payment options below. Donations may also be submitted to the LANL Foundation over the phone at 505-753-8890, or by requesting a donation envelope from tony@lanlfoundation.org.

LANS Match

Los Alamos National Security (LANS) has generously agreed to match all contributions made by LANS employees, LANL Affiliates, and Craft employees, up to $250,000, with the goal of over $500,000 in scholarships in 2014.

LANL employees may only make pledges through the online Oracle payroll deduction system in order to receive the LANS match. Please note that LANL employee payroll deductions will no longer be automatically renewed from year to year. Download Oracle instructions.

LANL Affiliates and Craft employees must use separate hard-copy forms in order to receive the LANS match. Download forms for Affiliates or Craft employees. The LANL Foundation administers the scholarship fund and ensures that all donor contributions go directly to student awards. The LANS match is subject to an 11% administrative fee. All donations are tax-deductible.


* Indicates a required field
* Title:
Mr. Ms. Mrs.
Other:
* First Name:
Middle Initial:
* Last Name:
* Company Name:
LANL/LANS Affiliate
Craft SOC Los Alamos
LANL or Contractor Retiree
Other:
* Work Address/ Mail Stop:
* Work City:
* Work State:
* Work Zip:
* Work phone:
* Email Address:
* Home Address:
* Home City:
* Home State:
* Home Zip:

* Giving and Payment Options

Please check each fund that you would like to support.

* My TOTAL GIFT for the entire 2014 LAESF Campaign year is: $
Note: If donating more than $9,999.99, please call our office to arrange your pledge.

* Payment Options

For the TOTAL GIFT indicated above:

I will pledge a monthly gift by credit card.
TOTAL GIFT will be divided by 12 months.

OR

I will pledge a one-time gift by credit card.
TOTAL GIFT represents a one-time donation.

OR

I will pledge a one-time gift by check.
TOTAL GIFT represents a one-time donation.

Please mail your check, made payable to the LANL Foundation to:
LANL Foundation
LAESF
1112 Plaza del Norte
Espanola, NM 87532

 


Designation of Funds

Feel free to designate my donation to funds where needed most

OR

I wish to designate my donation to the following funds:

(The sum of the $ amounts indicated in this section will be listed in TOTAL GIFT above.)
Los Alamos Employees’ General Scholarship Fund $
Los Alamos Employees’ Endowed Scholarship Fund $
Endowed Leadership Scholarship Fund $
Regional College/Returning Student Scholarship Fund $
The Senator Pete Domenici Endowed Scholarship Fund $
Northern New Mexico Tribal Business Scholarship Fund $

** We recognize all donors by name.  Do you wish to remain anonymous?N

Please indicate your spouse’s name if you would like to be recognized together:


   

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