Please print out, complete, and mail this form with your check or money order to:

CSUB
Office of University Advancement
9001 Stockdale Highway
Bakersfield, CA 93311-1099

Thank you for your support!

Name _________________________________________________________________

Street ________________________________________________________________

City ___________________________________ State _____ Zip ________________

Telephone ______________________

E-mail _________________________________
          (must have if electing to receive Donor E-Mail)

Amount Donated ________________________________________________________

Please check here if:

_____ I prefer not to be listed publicly as a CSUB Supporter
_____ I prefer not to receive the quarterly Donor E-Mail