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MAKE A GIFT TO HELP TALENTED YOUNG INVESTIGATORS BUILD THE FIELD OF SPORTS MEDICINE

If you would like to make a gift to the ACSM Annual Fund ...Training leaders for the next 50 years, please complete this form, and submit it electronically. If you would like to make an offline payment, please print this form (Annual Fund Gift Form) and either fax it to Tina Harland, Director, ACSM Foundation at (317) 634-7817 or mail it with a check or credit card payment information to the ACSM Foundation at the address listed on the form. If you have any problems or questions in completing this form, please email tharland@acsm.org.

Thank you.

 First Name:   MI:   Last Name:
Address:
City:
 State: Zip:
Country:
Phone:
 Fax:  
E-mail:

Yes! I wish to support the training of leaders for the next 50 years.

I/We donate to the Annual Fund:
$52 ($1 per week) $100 $150
$200 $1,000 Other

 

Please designate my contribution to (please indicate amount):

Unrestricted Gifts
Research Endowment
Clinical Sports Medicine Endowment
Education Endowment
Paffenbarger-Blair Epidemiological Fund
Michael L. Pollock Memorial Fund
Carl V. Gisolfi Memorial Fund
Doctoral Student Research Grants
Planned Giving/Contact ACSM

Please charge my credit card ($50 minimum on charges).
Card Number Expiration Date
(Please see note at the top of the page regarding credit card use)

Please enroll me in the:

Ring of Excellence $5,000 and above Pacesetter $200-$999
Joseph B. Wolffe Club $1,955-$4,999 Friend $52-$199
Founders Club $1,000-$1,954  

A formal acknowledgement letter will be sent to you via the US Postal Service. You may print this page before submitting for your records.

The American College of Sports Medicine is an organization qualified to receive tax-deductible gifts under IRS code section 501 (c)(3).

American College of Sports Medicine Foundation
P.O. Box 1440
Indianapolis, IN 46202-1440

This page was last updated on 5/1/08

©2005 ACSM. All rights reserved.


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