Giving

Make a Gift Form

Fill out this form, print and mail to:

Sandy T. Liarakos, CFRE
Executive Director of Development
UC San Diego Moores Cancer Center
UC San Diego Health Sciences
9500 Gilman Drive # 0853
La Jolla, CA 92093-0853

The UC San Diego Foundation is a 501(c)(3) non-profit organization.
Tax ID: 95-287-2494

Donor Information
Title
First Name
Last Name
Company Name (if appropriate) Phone (999) 999-9999
email (abc@mysite.example)
Address
City
State
Zip
Commemorative Gift
Name of Honoree
Send notification of this gift to:
Title
First Name
Last Name
Company Name (if appropriate)
Address
City
State
Zip
Gift Information
*Gift Amount $     *Confirm Gift Amount: $
My check made payable to the UCSD Cancer Center Foundation is enclosed.
Please use my Credit Card Credit Card Number:
Exp. Date: / (mm/yy)    Signature___________________________________________ hco
*Please tell us where to direct this gift.
  For the Cancer Center's greatest needs.        For the following area of cancer research and care.  
This completed form should be mailed to:
Sandy T. Liarakos, CFRE
Executive Director of Development
UC San Diego Moores Cancer Center
UC San Diego Health Sciences
9500 Gilman Drive # 0853
La Jolla, CA 92093-0853
For additional questions, please contact Sandy Liarakos at (858) 246-1569 or sliarakos@ucsd.edu.