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.
you for helping to build a perpetual endowment bearing our name which will exist
hundreds of years from now.
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
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
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/