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$ Fund Name: $ Gift Total The name(s) shown on my receipt for this gift should be: This gift is made in honor/memory of: Please acknowledge this gift to: Name: Address: City: State: Zip: My check is made payable to the University of Michigan . Charge my gift to MasterCard VISA AMEX Discover Account Number: Expiration Date: Signature: (Required) Name as it appears on the card: If you have any questions, please call the Gift Help Line at (888) 518-7888 (toll free) or (734) 647-61.

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