Cryptocurrency Donation Form

Cryptocurrency Donation Form

Complete this form to notify UA Services of each expected cryptocurrency donation. Contact Mike May with any questions.

Donor Full Name*

Donor Advance ID*

Donor Email Address*

Name of Cryptocurrency (e.g., Bitcoin)*

Amount (e.g., 0.5 Bitcoin)*

Gift Purpose*

Select

Agency*

Select or enter value

Allocation Name and Number*

Anticipated Gift Date

Comments/Special Instructions

Development Officer Name*

Development Officer Email Address*

Send me a copy of my responses

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