Print this page

I would like to donate:
Other amount: $__________

I would like to be listed on the Hayes Center's Manuscripts Donor Page

Is this a joint contribution? Yes  No

This is a gift from myself and ____________________________
(Only applicable if joint contribution is marked "Yes")

Please make this an anonymous donation.

I would like to make this donation: in Memory of  |  in Honor of  (circle one)
Name: ________________________________

I would like to receive News from the Manuscripts Collections via e-mail.

Personal Information
Prefix: ______
First Name: ___________________
Middle Initial: _____
Last Name: ___________________
E-mail: ______________________________
Telephone: _________________

Shipping Information
Address 1: ________________________
Address 2: ________________________
City: ___________________
State/Province: ______________
Zip/Postal Code: ________
Country: ___________________

Credit Card Information
Credit Card Type: VISA
Card Number: _____________________
Expiration Date: Mth: ____ / Yr. ____

Were any services or materials at our site of special importance to you?

May we publish your comments either wholly or in part for publicity purposes?
YES, but please do so anonymously.
YES, and you may attribute comments to me.
NO, these comments are for your internal use only and may not be published.

Mail this completed form to Nan Card, Curator of Manuscripts, Rutherford B. Hayes Presidential Center, Spiegel Grove, Fremont, Ohio 43420. Checks should be made payable to the Hayes Presidential Center Manuscripts Fund.