o I would like to contribute to the campus campaign.o I would like my gift to be anonymous.o This gift is made jointly with my spouse/partner whose name is_______________________

DESIGNATED GIFT SELECTION Your gift is tax deductible to the extent allowable by law. If you would like to consider making a pledge over a period of time or discuss a planned gift, contact Dina Harris at (574) 520-4131 or e-mail diharris@iusb.edu. To choose additional account numbers and information see reverse side. You can choose more than one account. I want to make a gift to...

Account Name__________________________________ Account #_______________________________ $ ___________________

Account Name__________________________________ Account #_______________________________ $ ___________________

Account Name__________________________________ Account #_______________________________ $ ___________________

CAMPUS-WIDE ACCOUNT Donations to the Chancellor’s Fund are used for general support of IU South Bend. Uses may include non-traditional student scholarships, diversity programs speakers series, musical events, outreach to K-12 schools, as well as many other worthwhile projects.

o Chancellor’s 100 $______________ Account #I320003724

PAYMENT OPTIONSCheck/Credit Card o Enclosed is my check in the amount of: $_____________________ (make check payable to the IU Foundation)

o Please charge my ___Visa ___MasterCard ___American Express ___Discover in the amount of $_____________________

Account #___________________________ Expiration Date _____/_____ Signature (required)_____________________________

Payroll Deduction o I wish to make a pledge through payroll deduction of: $___________per pay period for _____months. or ___indefinitely (Note: minimum $5 per pay period, minimum four pay periods)

Employee Pay Type ___10 month ___12 month ___Biweekly Employee ID# (required)_____________________________

Total Gift Amount $___________________________ Signature (required)______________________________________________ This deduction (check if applicable)o replaces my current payroll deduction o should be added to my current payroll deduction (continue my current deduction, also)

For Development Office Use ONLY, Crimson ID #___________________________________________________ PME: IU19BANISBFS11NATF1G9

CAMPUS CAMPAIGN ’19 EMPLOYEE GIFT FORMPlease return this form to: Dina Harris, Administration Building, Room 240 G.

Visit the Campus Campaign website: development.iusb.edu/campus-campaignQuestions? contact Dina Harris at 574.520.4131 or diharris@iusb.edu

Fundraising Disclosures: http://go.iu.edu/89n

INDIANA UNIVERSITY SOUTH BEND

YOUR GIFT IS AN OPPORTUNITYfor students to excel and strengthen their commitment to IU South Bend.

CAMPUS CAMPAIGN ’19

TOGETHER WE

CHANGELIVES

“This scholarship helped me tremendously. The Opportunity Scholarship was one of two scholarships I received this year, and I am forever grateful.”

“As a full-time student who works multiple on-campus jobs every semester, this scholarship made it so I could cut back on hours and focus on my classes. I am extremely thankful for the opportunity I’ve been given.”

“This scholarship has allowed me to continue

being a diligent student while also being the best mother,

fiancée, daughter, and sister that I can be. I can never

thank the donors enough.”

“I cannot express my gratitude enough for receiving the Alumni Honors Scholarship.”

“The scholarship I received gave me the ability to become an unofficial ambassador of Mexico in the States. The trip to Oaxaca changed my life and opened my eyes to real-world problems, as well as real-world cultural differences that have improved my life. I have first-hand experiences and connections there, and they will forever be a part of my life.”

REAL LIVES. REAL IMPACT.

THE GIFT THAT KEEPSGIVING. IT’S TRUE. Your gift to IU South Bend is so important, the State of Indiana will pay you for it.

It’s right there on Form CC40.

Tell them how much you gave and they’ll give you half of it back (up to $100 if you’re filing singly, $200 if you’re filing jointly)!

GIFT AMOUNT

TAX CREDIT (JOINT / SINGLE)

$50

$100

$200

$400

$500

$25 / $25

$50 / $50

$100 / $100

$200 / $100

$200 / $100

IT’S MONEY BACK IN YOUR POCKET.

It’s a credit that reduces the tax you owe. And don’t forget the federal deduction, if you itemize.

ACADEMIC AFFAIRSI320003778 Academic AffairsI320013603 Community Engagement FundP370007869 Eldon Lundquist Faculty Fellows FundI380010535 Lester M. Wolfson Research

ADMINISTRATIVE AND FISCAL AFFAIRSI320003790 Financial and Administrative Services

ALUMNI RELATIONSP370007957 Alma and Bill Powell Alumni Endowed ScholarshipI320003812 Alumni Affairs Non-Traditional Student ScholarshipP370007886 IUSB Alumni Association Scholarship Endowment FundI320003885 IU South Bend Alumni Honors ScholarshipI320013260 IU South Bend Alumni Office Project and Improvement FundI380013318 IU South Bend Jubilee Alumni ScholarshipI320003867 IU South Bend Sueño Annual ScholarshipP370007932 Jamshid Mehran Honorary Scholarship in FinanceP370007665 Joann Phillips Masters of Social Work Alumni ScholarshipP370007920 Sueño Endowed Scholarship

ARTS, ERNESTINE M. RACLIN SCHOOL OF THEP370007960 Bradley A. Thornburg Memorial Scholarship for the Visual ArtsI320003727 IUSB ArtsI320003854 IU South Bend Bartok Quartets FundI380010544 IU South Bend Ernestine M. Raclin School of the Arts FundI380010554 IU South Bend Piano StudioI320012898 IU South Bend Raclin School of the Arts Steinway FundI320013228 IU South Bend Raclin School of the Arts String ScholarshipI380010559 Harold and Doreen Zisla Art ScholarshipP370007893 Langland Fine Arts ScholarshipI320012088 Raclin School of the Arts Performance FundI320003807 Robert W. Demaree, Jr. ScholarshipI320003823 Steinway Piano Fund P370007945 Virginia Morrow Voice Scholarship P370007946 Barton Music TechnologyI320014122 IU South Bend Communication Studies

ATHLETICSI320013018 Athletic Training FundI320003735 IUSB Athletic Department FundP370007918 IUSB Athletic Scholarship FundI320012193 IU South Bend Baseball TeamI320012149 IU South Bend Cross Country TeamI320003887 IU South Bend Lady Titans VolleyballI320013404 IU South Bend Men’s Tennis TeamI320012912 IU South Bend Women’s Softball TeamI320013405 IU South Bend Women’s Tennis TeamI320003835 Lady Titans Basketball FundI320003829 Titans Men’s Basketball Fund

BUSINESS AND ECONOMICS, JUDD LEIGHTON SCHOOL OFP370007876 George Wing Memorial ScholarshipI320003745 Gerald E. Harriman Scholarship FundI320003816 IUSB Beta Gamma Sigma Induction DinnerI320003737 IUSB Bureau of Business & Economic Research FundI320003810 IUSB Decision Sciences FundI380010532 IUSB Division of Business and Economics FundI320003780 IUSB EconomicsI380010538 IUSB Entrepreneurship FundI320003783 IUSB Marketing FundI320013317 IU South Bend Annual Business ScholarshipsI380010549 James Pattillo Memorial ScholarshipI320003802 John Swanda, Jr. Honor FundI380010536 Manohar D. Nasta Memorial Scholarship

I320013145 Monle Lee Advertising ScholarshipI380010540 Robert N. Robinson Memorial ScholarshipI320003738 South Bend Accounting Department FundI320003736 South Bend Graduate Business Fund

CENTER FOR A SUSTAINABLE FUTUREI380012603 Michiana Sustain the Future ScholarshipI320003852 Sustainable Future FundI320011535 IU South Bend Sustainability Lecture Series

CHANCELLOR’S FUNDI320003724 South Bend Chancellor’s Fund

CIVIL RIGHTS HERITAGE CENTERI320003849 Engman Natatorium FundI380010570 IUSB Civil Rights Heritage Center at the Engman NatatoriumI320003832 Lester C. Lamon ScholarshipI320013915 IU South Bend Freedom Summer Class

COMPUTER AND INFORMATION SCIENCESI320003809 IUSB Computer and Information SciencesP370007911 John P. Russo Fund for Academic ExcellenceP370007917 William J. Knight Fund for Academic Excellence in Computer and Information Science

CONSTRUCTIONI320003879 IU South Bend Campus Improvement Fund

CRIMINAL JUSTICEP370007938 Cadet Kelly Dulcet Memorial ScholarshipI320003880 IU South Bend Criminal JusticeI320003794 Walt Risler Memorial Scholarship

DENTAL EDUCATIONI380012029 Dr. Alfred Fromm Scholarship for Academic ExcellenceI380010530 IUSB Dental Auxiliary FundI320003753 IUSB Dental Education Department FundI380012097 IUSB Dental Hygiene Fund I320003866 IU South Bend Dental Clinic Equipment, Furnishings and Technology FundI320003897 IU South Bend Dental Clinic Student Philanthropy Fund

EDUCATION, SCHOOL OFI320003874 Indiana University South Bend Educational Leadership Program I320013304 IU South Bend Community Counseling ClinicI320003764 IU South Bend Counseling and Human Services Conference FundI320003760 IU South Bend Counseling and Human Services Department FundI320003762 IU South Bend Education ScholarshipI320003890 IU South Bend Educational Resource Commons FundI320003777 IU South Bend Elementary Education Program FundP370007896 IU South Bend School of Education Faculty ScholarshipI320003723 IU South Bend School of Education FundI320011233 IU South Bend School of Education P-12 Summer ProgramI320013267 IU South Bend School of Education P.E.A.C.E.able Learning ProjectI320003875 IU South Bend Secondary Education Program FundI320003761 IU South Bend Special Education Program FundP370007971 IU South Bend Underrepresented Teacher Scholarship

ELKHART CENTER, IU SOUTH BENDI380010534 IUSB Off Campus Programs FundI320012973 IU South Bend Elkhart Center Improvement Fund

ENGLISHP370007948 Eileen Bender Endowed ScholarshipI320003731 South Bend English Department FundP370007959 The Bender Scholars Program

EXTENDED LEARNING SERVICESI320003877 IU South Bend Distance Learning Fund

FRANKLIN D. SCHURZ LIBRARYP370007892 Franklin D. Schurz Library Collection EndowmentI320003739 Franklin D. Schurz Library FundI320013161 IU South Bend Schurz Library Education and Outreach ProgramsP370007943 Michele C. Russo Library Student Worker Scholarship Endowment

GENERAL SCHOLARSHIPSP370007884 Chad Edward Pearson Memorial Scholarship FundP370007966 Chancellor Terry L. Allison Scholarship in Creativity and InnovationP370007970 Ilene G. and Richard D. Sheffer Rwandese ScholarshipI320003824 IU South Bend Black Council ScholarshipI320003743 IUSB General Scholarship FundI320003800 Thomas Smith Memorial FundI320013351 “Your Dreams are Possible” Karen White Scholarship

GENERAL STUDIESP370007871 IUSB General Studies EndowmentI320003798 IUSB General Studies ProgramI320003865 Ted Hengesbach Scholarship

HISTORY AND PHILOSOPHYI320003750 IUSB History Department FundI320003746 South Bend Philosophy Department Fund

HONORS PROGRAMI320003784 IUSB Honors Program

INFORMATION TECHNOLOGIESI320003788 IUSB University Information Technology Services

INTERNATIONAL STUDENT SERVICESI320003748 IUSB International Programs Fund LIBERAL ARTS & SCIENCES, COLLEGE OFI320011457 IU South Bend Liberal Arts & Sciences Enrichment ProgramsI320003893 IU South Bend Master of Public Affairs ProgramI320012004 IU South Bend Wolfson PressI320003732 IUSB Liberal Arts & Science FundP370007936 Lynn R. Williams Dean’s Scholarship

MASTER OF LIBERAL STUDIESP370007963 Jennifer Jo Szendrey Memorial Graduate MLS ScholarshipI320003776 Master of Liberal Studies

MATHEMATICSI380010561 IU South Bend Faculty and Alumni Scholarship for Excellence in Mathematical SciencesI320003730 IUSB Mathematical Sciences

NURSING & HEALTH PROFESSIONSI380010562 Dean Mary Jo Regan-Kubinski Memorial Scholarship in NursingI380013421 Dwyer College of Health Sciences Janet N. Gilroy Memorial ScholarshipI320003781 IUSB Nursing ScholarshipI320003876 IU South Bend Health and Wellness CenterP370007969 Lois A. Vanderhoof Nursing ScholarshipI320003741 South Bend Nursing Department FundI320013238 Vera Z. Dwyer College of Health Sciences Division of Health Sciences Fund I320014245 IU South Bend Vera Z. Dwyer College of Health SciencesI320014450 IU South Bend Clincal Laboratory Science

POLITICAL SCIENCEI320003884 IU South Bend American Democracy Project FundI320003882 IU South Bend Social Action Project (SOCACT) FundI320003782 IUSB Political Science

PROFESSIONAL DEVELOPMENT AND LIFELONG LEARNINGI320003754 IU South Bend Professional Development and Lifelong Learning FundPSYCHOLOGYI320003767 IUSB Psychology Department Fund

RADIOGRAPHY/MEDICAL IMAGINGI320003815 IUSB Radiography FundI380010558 Radiography Education Scholarship FundI380012110 Radiologist Scholarship P370013305 Radiology, Inc., Joseph L. Wind Memorial Scholarship

SCIENCESI380010560 Dr. Ann M. Grens Biology ScholarshipP370007907 George Nazaroff ScholarshipI320003779 Joseph J. Ross AwardI320003733 South Bend Biological Sciences Department FundI320003752 South Bend Chemistry Department FundI320003749 South Bend Physics Department Fund

SOCIAL WORKI380013548 Daniel E. Steinberg Memorial Scholarship in Social WorkP370007665 Joann Phillips Masters of Social Work Alumni ScholarshipI380010400 Karen Schram Davies Memorial Graduate Scholarship in Social WorkI320012482 Titans Feeding Titans Food Pantry Fund

SOCIOLOGY & ANTHROPOLOGYI320003886 IU South Bend Sociology and Anthropology Undergraduate ResearchP370007939 Linda Marie Fritschner Fund for Academic Excellence in Sociology or AnthropologyI320003747 South Bend Sociology and Anthropology Department Fund

STUDENT AFFAIRS & ENROLLMENT MANAGEMENTI320003881 IU South Bend Office of Student Life FundI320003740 South Bend Student Services FundI320003889 Student Services, Faculty and Student Engagement Initiative

STUDENT SERVICESI320014563 IU South Bend Student Emergency Relief Scholarship I320003834 IUSB Student Counseling CenterI320003808 Student and Community Relations Fund

UNIVERSITY ADVANCEMENTI320003822 IU South Bend University Advancement FundI320003728 IUSB 21st Century Fund

UNIVERSITY CENTER FOR EXCELLENCE IN TEACHING (UCET)I320003791 University Center for Excellence in Teaching (UCET)

VETERAN SERVICES I380013795 IU South Bend Veteran and Family Relief Scholarship

WOMEN’S AND GENDER STUDIESI320003825 Gloria Kaufman Memorial FundI320003820 IU South Bend Women’s and Gender StudiesI320003851 Patricia McNeal Agent of Change Award

WORLD LANGUAGES AND TRAVELP370007962 Dr. Alfred J. Guillaume, Jr. International Study Scholarship P370007933 Gabrielle Robinson Study Abroad Travel EndowmentI320003853 IUSB World Language Studies Department Fund

YOUR GIFT IMPACTS STUDENTS + FUTURE GENERATIONS.Invest in our students and their futures, and inspire a lifetime of learning. Your support deepens the impact IU South Bend has on the lives of our students—and we are, in turn, impacted by our students’ visions, growth, and leadership.

Together we have raised nearly $1,857,597, since the inaugural campus campaign kicked off in 2006. We are reaching higher this year with a goal of $306,608. You may designate any of the accounts to be impacted by your 2019 Campus Campaign gift.

Please consider making your gift during the first six weeks of the campaign—February 11 through March 29, 2019.

ANY AMOUNT MAKES A DIFFERENCE Even $5 per pay period can have a significant impact in a students’ education.

Gifts may be made by payroll deduction, check, or credit cards—Visa, MasterCard, Discover, and American Express.