East Tennessee State University
Retirees Association (ETSURA)
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East Tennessee State UniversityRetirees Association (ETSURA) |
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Enclosed is the applicable life membership fee application. It is understood that this is a non-refundable deferred gift to the ETSURA Endowed Scholarship Fund in the ETSU Foundation. The funds will be invested by the university with the income being used for current expenses of the association until my (our) death at which time it (one half if husband or wife) will be transferred to the Endowed Scholarship Fund. It is understood that any benefit received from ETSURA, the university or its foundation for this contribution will be of nominal value and it is fully deductible for tax purposes in the year paid. |
NAME OF MEMBER: __________________________________ NAME OF SPOUSE:
____________________________
ADDRESS:
(Street)
___________________________________________________________________________________
(City)
________________________________________________________________ (State) ______
(ZIP) _____________
TELEPHONE: (
_____ ) ______________________ EMAIL:
__________________________________________________
INDIVIDUAL MEMBERSHIP
_____________ $100.00
HUSBAND AND WIFE
_____________ $150.00
ACCOUNT NO.: Fund: 821410; Org: 79990; Banner Account: 29300; Program: 999; Chart E
Make check payable to ETSU and mail
to:
East Tennessee State University
ETSURA, Office of Human Resources,
Box 70564
Johnson City, TN 37614-1707.
Your check will be your receipt.
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Back to ETSU Human Resources Page |
Mailing Address: Office of Human Resources
ETSU Box 70564
Johnson City, TN 37614-1707
Telephone: 423-439-4457
Fax: 423-439-8354
TDD: 423-439-4710
Office Hours: 8 a.m. to 4:30 p.m. E.S.T. Monday
- Friday
Office Location: Rooms 307 and 311, Dossett Hall
Updated on 11/07/07
