Support the USI Foundation

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

The USI Foundation
8600 University Blvd.
Evansville, IN 47712

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 USI Foundation Supporter
_____ I prefer not to receive the quarterly Donor E-Mail