YES! I would like to stash my cash with the NSS!
Please fold the completed form in half and secure with tape to mail. Or fax to 256.851.9241. You can download a printable Word document, or an RTF document.
Name: ___________________________________ (please print)
NSS Number: _______________
Tel: _______________________ e-mail: _____________________________________
I would like to donate to the National Speleological Society:
____ $10 ____ $15 ____ $20 ____ $25 ____ Other
____ Just this once ____ Once a month ____ Quarterly ____ Once every six months
Donations to begin in: __________ (month) __________ (year)
I would like my donation to be earmarked for the following restricted fund or for unrestricted use in the general operating fund: (Mark one below)
_____ Endowment Fund
_____ Save the Caves Fund
_____ (Cave) Educational Grants
_____ NSS Repair Funds
_____ Ralph W. Stone Fund (Research Grants)
_____ NSS Cave Preserve Fund
_____ Other _________________________________________
For a complete list of NSS Funds, go to http://www.caves.org/nss-business/bog/sec-18.html and to http://www.caves.org/nss-business/bog/app-c.html for NSS funds held by the NSF.
Please charge the donation to my credit card:
_____ VISA _____ MasterCard
Credit Card Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Expiration Date: ____/____/____
Name as it appears on the credit card: _____________________________________________
I authorize the NSS to charge my account the amount I have specified above at the interval indicated. I understand that I may change the amount of my contribution or cancel this agreement by sending (e-mail, fax, snail-mail) written instructions to the NSS Office.
Your signature: _________________________________ Date ___/___/___
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