• Gifts made in lieu of tuition payment for services

• Subscription,membership,or any other fees for which benefits are received. • Gifts of real or personal property
• Cumulative gifts from several individuals reported as one contribution

• Gifts to organizations that support schools,but are not schools or foundations that support

• Gifts made by or through community trusts or similar organizations,including charitable

• Public and private • Prekindergarten
• Elementary schools • Secondary schools • Junior colleges
• Colleges

• Graduate schools

• Technical or vocational schools • School districts
• Educational foundations that support schools located within the United States

Contributions must be given,not just pledged.Qualifying gifts will be matched from $25 – $6,500

in attendance at a school do not qualify under this program.

Eligible participants may request that a gift be matched up to one calendar year after the gift has been

Wells Fargo reserves the right to approve or decline a match request.

board members may obtain forms by contacting Community Support Programs at

• Must be from the team member’s personal funds,which has been paid directly to an approved

• The minimum eligible gift for matching is $25.For installment gifts,each match request must be submitted separately and meet the $25 minimum gift requirement.
• The annual limit for each donor is $6,500 and is based on the date of the gift.

• Gifts must be in the form of check,credit card,or marketable securities with a quoted market value.Checks written from a family foundation or trust are not eligible for a match.
• Gifts of securities are valued based on the average of the high and low on the date of the gift.No

Matching gift disbursements are made by our program administrator,JK Group,Inc.,based in Princeton,NJ.

[Please direct matching gift questions to

Complete Part 1 of this form.Complete one form for each gift.

Please print or type.Send this form and a copy of the program guidelines to the recipient organization.

Team Member Name

Team Member Employee Number

City
	State
	ZIP Code

	Amount of Gift (min $25)
	Amount to Be Matched (min $25)
	
I made my donation by (please check one):

c Check/credit Card     c Stock/Securities

If stock/securities,list the number of shares and name of securities/stock:

Verify receipt of gift.Complete Part 2 of this form.Please print

or type.If this is your first matching gift request to theWells Fargo Educational Matching Gift Program,

Employer Identification Number (EIN)
	Name of Accredited Educational Institution

City
	State
	ZIP Code

		

• This accredited education institution meets the eligibility requirements of theWells Fargo

• Neither the donor norWells Fargo will derive any personal material benefit from this gift or

• Neither my family nor I will derive any direct or indirect financial or material benefit from this

• I authorize the above-named school to report this gift toWells Fargo for the purpose of applying

• My gift is a voluntary contribution,that it fully complies with the provisions of the program

• I have not been nor will I be reimbursed or compensated by anyone for this contribution.

• I have read and understood the guidelines of theWells Fargo Educational Matching Gift Program. • Any misrepresentation by me of the statements made herein will forfeit my rights to any

• By signing this document,I understand that any misrepresentation of information violates

Wells Fargo’s Code of Ethics and Business Conduct.

• This institution is in full compliance with the anti-terrorism laws legislated by the USA Patriot Act. In addition,by countersigning the matching gift application,I agree that this institution will not

• I am authorized to attest to the above statements and have sufficient knowledge to do so.

• I have read and understand the guidelines of theWells Fargo Educational Matching Gift Program.

Authorized School Personnel Name

Signature of Authorized School Personnel

Signature ofTeam Member