Proceeds from this program support a scholarship for an incoming student in the fall. Your Information Name Address City State - Select One - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming _________________________________ Alberta British Columbia Manitoba New Brunswick Newfoundland North West Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec (QC) Quebec (QUE) Saskatchewan Yukon Territory _________________________________ International Zip Phone Number Email Tribute to be displayed on video scoreboard * Please limit to 100 characters. Optional Photo 10 MB maximum file size. JPG, PNG, and GIF only. When you click the "Submit Form" button, you will be automatically directed to Michigan Tech's online giving page where you can make your $20.23 tribute gift with a credit/debit card.
