Address:

Peking University Education Foundation (USA)

1650 South Amphlett Boulevard, Suite 118

San Mateo, CA 94402 USA

Donor’s Information:

Please include a note with your information along with your check following the instruction below:

1. Name

_______  (First name), _______ (Last name)

_______  (Full name in Chinese if you have one)

2. Phone number

____________ (Land line)

____________  (Cell phone)

3. Email address

____________

4. Mailing address

____________  (Name)

____________  (Title)

____________  (Corporation or Organization)

____________  (Street)

____________  (City, State and Zip Code)

5. Donation instruction

____________  (Please tell us the specific program that you

want to support or put “General Fund”)

6. For Peking University alumni, please provide us with your year enrolled and your major

____________  (Year Enrolled)

____________  (Department and Major)