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RETIREES ASSOCIATION SCHOLARSHIP ENDOWMENT CONTRIBUTION FORM

University retirees have generously answered the call during the past years for contributions to the Dr. Mack P. Davis ETSU Retirees Association Scholarship.   The earnings from our endowment provide scholarships to entering freshmen or transfer students who have good academic credentials and who need financial assistance.  The scholarships may be renewed for up to three years if the recipients remain in good standing and continue to be qualified, as determined by the University Scholarship Committee. 

Thank you for helping to build a perpetual endowment bearing our name which will exist hundreds of years from now. 
Deserving students will benefit from your generosity today and many tomorrows. 


NAME OF MEMBER: _______________________________ NAME OF SPOUSE: _________________________

ADDRESS: (Street) _____________________________________________________________________________

(City) _____________________________________________________________ (State) ______ (ZIP) __________

TELEPHONE: ( _____ ) ____________________ EMAIL: ______________________________________________

AMOUNT PAID: ______________________________________________________________________________

MEMORIAL TO OR IN HONOR OF: _____________________________________________________________

PLEASE NOTIFY OF THIS GIFT: ________________________________________________________________

Investment Account: Banner 653110/2552/550

Make  check  payable  to  ETSU  and  mail to: 
East Tennessee State University Retirees Association
Office of Human Resources, Box 70564
Johnson City, TN 37614-1707. 
Your check will be your receipt.
 

Mailing Address:  Office of Human Resources
ETSU Box 70564
Johnson City, TN  37614-1707
Telephone:  423-439-5825
Fax:  423-439-8354

Office Hours:  8 a.m. to 4:30 p.m. E.S.T. Monday - Friday
Office Location:  Room 308, Dossett Hall

Return to: http://www.etsu.edu/humanres/etsura/