ACLM Foundation
Corner
|
|
The ACLM Foundation is proud to
offer the membership of ACLM a way to honor, memorialize,
or wish a speedy recovery to friends, relatives
and fellow members while contributing to the educational
goals of ACLM. Each contribution will be acknowledged
to both the honoree and donor, and hopefully will
become a regular listing in Notes from the President.
Such contributions are considered tax deductible
by the IRS and will go to finance such projects
as the National Health Law Moot Court Competition
at Southern Illinois University School of Law, Annual
Meeting speakers, Legal Medicine and Bioethics writing
contests, and Textbook awards to outstanding
medical and law school students. The donation form
may be printed
out and mailed to the ACLM office (Attn: ACLM Foundation)
at the address below. Let us make this a growing
part of ACLM's collegial life.
|
|
ACLM FOUNDATION
DONATION FORM
|
|
(Please type or print)
|
|
ACLM Foundation
1100 E. Woodfield Rd., Suite 520
Schaumburg, IL 60173
Phone: (847) 969-0283 Fax: (847) 517-7229
|
| |
|
This gift is being made
|
| |
| In Honor of: _______________________________
for _________________________________. |
|
(Specify
Reason)
|
| |
| In Memory of: __________________________________________________________________. |
| |
| To Wish: ______________________________________________________
a speedy recovery. |
| |
|
|
|
|
| |
| ACKNOWLEDGMENT TO: |
AMOUNT (please circle)
$25
$50
$100
$250
$500
$1,000
$2,000
$2,500
$5,000
$7,500
$10,000
$____________
(Other amount) |
|
|
|
Name:________________________________________
|
|
Address:______________________________________
|
|
City, State, Zip:
_________________________________
|
| |
| DONOR: |
|
Name:________________________________________
|
|
Address:______________________________________
|
|
City, State, Zip:
_________________________________
|
| |
|
|
Thank you for your donation!
|
|
| Click here to Print! |
|
|