|
FOUNDATION FOR REHABILITATION PSYCHOLOGY
(FRP)
FRP is a charitable (501(c)3) corporation whose mission is: To improve the lives of persons with chronic illness and disability through research and professional education in Rehabilitation Psychology.
I would like to make a gift to the Foundation for Rehabilitation Psychology in the amount indicated:
__ $100 __ $250 __$500 __ $750 Other: __________
LEADERSHIP GIFT
__ $3,000 __ $5,000 __ $10,000 __ $15,000 Other: _____________
Leadership Gifts may be paid over 1 to 3 years.
Please indicate your choice: _____ year(s).
__ I would like to speak with a member of the Board of Trustees about making a
Visionary Gift of $25,000 or more.
__ I would like to receive information about planned giving or bequests.
DESIGNATE YOUR CONTRIBUTION:
Please allocate my contribution to the area(s) indicated:
___ Mitchell Rosenthal Student Research Scholarship Fund
___ Bernard Brucker Continuing Professional Educational Fund
___ General Fund
My gift is in honor of: ______________________________________
My gift is in memory of: ____________________________________
Please send an acknowledgement letter to this address:
DONOR INFORMATION:
Name _____________________________________
Address _____________________________________
City _____________________________________
State/Zip Code ________________________________
Telephone ___________________________________
E-mail (Foundation use only) ______________________
___ Check here if you do not want to be recognized as a donor.
Acknowledgement of your gift and a receipt will be mailed to you.
Print this page, complete the form, and make your check payable to:
Foundation for Rehabilitation Psychology
Mail to: Foundation for Rehabilitation Psychology
c/o The Columbus Foundation
1234 East Broad Street
Columbus, OH 43205
~ OR ~
Give to our endowment fund online: http://columbusfoundation.org/give/
Click on: "Give to a Fund"
Fund Name: Foundation for Rehabilitation Psychology Fund
For questions contact: Allen Heinemann, PhD, Secretary/Treasurer
312.238.2802
a-heinemann@northwestern.edu
|
