Donate to the Bollens-Ries-Hoffenberg Lecture and Scholarship Endowments

The Bollens-Ries-Hoffenberg Lecture Series is honored to support merit-based scholarships for political science students. We encourage you to support academic achievement by donating to the lecture services and/or scholarship fund.

Name: ______________________________________________________________
          PLEASE PRINT: Last Name, First Name

Address: _______________________________________     Home Work
          Street Address

____________________________________________________________________
City                                                  State                              Zip Code

Phone Number: (___) ___________     E-mail Address: ____________________

Would you like to be contacted via: E-mail or, Regular mail
Class Year: __________

Yes, I would like to give to the Bollens-Ries-Hoffenberg Lecture Series (Fund 04473). This fund is used to support annual lectures relating to public policy and/or public administration issues.      $ __________

Yes, I would like to give to the Bollens-Ries-Hoffenberg Scholarship Fund (Fund 42538). Once endowed this fund, established in 2005, will finance student scholarships and/or student internships in local government.      $ __________

This is a joint gift. Spouse/Partner Name: ________________________________

I prefer to pay by:
Check made payable to the: UC Regents
Credit card:
     MasterCard      Visa      Discover      American Express

Name on Card _________________________________________________
                              PLEASE PRINT
Card Number: ________________________________________________________

Expiration Date: _______________     Amount to be charged: ______________________

Please review UCLA and the UCLA Foundation’s Disclosure Statement for Prospective Donors at www.uclafoundation.org/disclosures or contact Peter Evans at (310)825-8633.


Please print this form and return to: Bollens-Ries-Hoffenberg Lecture, UCLA Department of Political Science, 4289 Bunche Hall, Box 951472, Los Angeles, CA 90095-1472 or fax (for credit cards) to: 310-825-0175