Title * Name * Surname * Email * Address * Please remember to provide your postal code Date of Graduation * Year Year194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Leave a Bequest * I intend to leave a bequest to UCT when I next update my Will. Please send me further information I have already included UCT in my Will, and wish to be included in the UCT Legacy Society Purpose of Bequest * Purposes for which you wish your bequest to be used Field of Study * Specific Field of Study (If Applicable) Recognition * Recognise me publicly I want to remain anonymous Signature * Please insert initial and surname as signature Date Signed * Year Year2019 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Place Signed * Query/comment Leave this field blank