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University of Texas Southwestern Medical School  
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Make a Donation to UT Southwestern
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Welcome to our online donation page. Please follow the steps below to make a credit card contribution to UT Southwestern and help us accomplish our mission:

  • To improve health care in our community, Texas, our nation, and the world through innovation and education;
  • To educate the next generation of leaders in patient care, biomedical science and disease prevention;
  • To conduct high-impact, internationally recognized research;
  • To deliver patient care that brings UT Southwestern's scientific advances to the bedside — focusing on quality, safety, and exemplary patient service.


* Denotes Required Information
Donor Information
  * First Name:    
    Middle Name:    
  * Last Name:    
    Is this a Joint Donation? Yes    No    
    Joint Donor's Title:    
    Joint Donor's First Name:    
    Joint Donor's Middle Name:    
    Joint Donor's Last Name:    
    Relationship to Donor:    
    This Donation is made on behalf of a company:    
    Mailing Information of Donor    
  * Address:    
  * City:    
  * State:
  * Zip Code:    
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    Home Phone:    
    Office Phone:    
    Cell Phone:    
  * E Mail:    
      Please keep me informed about the latest advances from UT Southwestern
    Donation Information    
  * Amount:

    If for specific use or multiple designations, please specify:
      I prefer to make this donation anonymously.
    Payment Information    
  * Name as it Appears
on Credit Card:
  * Credit Card Type:    
  * Credit Card Number:
(Please do not use spaces or special characters)
  * Expiration Date: (mm/yyyy)    
  * Card Security Code:  Help
(Please click on the Help icon to find your Card Security Code)
    Billing Address (if different from Donor Information)  
  * Address:
  * City:
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  * Zip Code:
    In Honor or Memory of (Optional)
    Tribute Options:
    This gift is in recognition of:
    Please send notification of my gift to:
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    Relationship of the person notified to the honoree:    
    If you would like more than one individual notified of your gift, please call the UT Southwestern Development Office at 214-648-2344.    
  * Will your gift be matched by your employer?    
    Yes No      
    Employer Name:    
    Please mail your matching gift form to:

Office of Development
UT Southwestern Medical Center
5323 Harry Hines Boulevard
Dallas TX, 75390-9009
    Other Information    
  * What is your relationship to UT Southwestern?    
      I am:    
    If Other, please specify:    
    If you have questions or need help with this form please contact the UT Southwestern Development Office at 214-648-2344