DONATION / MEMBERSHIP FORM


DIRECTIONS:     Please complete and submit with your charitable contribution to:

Engineers Dedicated to a Better Tomorrow
P.O. Box 2486
Menlo Park, CA 94026-2486

FAX: (650) 323-8452

____ YES, I want to help further the mission and activities of DedicatedEngineers by making the following tax-deducible
     charitable contribution:

                  ___$25*                                      ___ $35**                                   ___ $50***                     
            ___ $100 (Bronze)****             ___ $250 (Silver)                        ___ $500  (Gold)  
            ___  $1000 (Platinum)                 ___ Other                                                           

*  - All donations of $25 or more qualify the donor for a one-year membership in DedicatedEngineers, receiving full membership benefits (see below for details).

** - Donate $35 and receive an official DedicatedEngineers coffee mug as a thank-you gift.

***- Donate $50 or more and receive an official DedicatedEngineers “13-in-1” Multi-Function Tool (providing pliers, wire cutter, mini-saw, two screwdrivers, punch, ruler, two knives, hook remover, bottle opener, can piercer, and file).

****- All donations of $100 (Bronze level) or more receive Sponsorship recognition (see below for details).

DedicatedEngineers is formally recognized by the IRS as a 501(c)(3) tax-exempt charitable non-profit – thus, your charitable contribution is tax-deductible to the full extent provided by law.

___ I am interested in potentially helping to sponsor a specific program, project, or other initiative/effort through DedicatedEngineers’ Special Sponsorship Program – please contact me to discuss possibilities.

Donor Information:*  

Prefix:  ____  Mr.   ____ Mrs.  ____ Ms.  ____Prof.  ____ Dr.
__ Name: _____________________________________     __ Mailing Address ( ___ Home  ___ Work ):
__ Title/Position: _______________________________     ______________________________________________
__ Employer Name: _____________________________      __ City/State/Zip: ________________________________
__ Div/Dept: __________________________________      __ Work Phone:_________________________________
__ Email: _____________________________________      __ Fax:  _______________________________________

* - DedicatedEngineers’ publishes a Resource/Member Directory made available to our members and sponsors. If you do not wish to have some of the above contact info included in the Directory, simply check the box(es) next to the specific information that you want excluded. To withhold all contact info, CHECK HERE: ___

Please publicly acknowledge this gift as a contribution from: ________________________________________________

Donation VIA:

 _____ Check (payable to Engineers Dedicated to a Better Tomorrow); Check #:                    
    
Bill My: _____ Visa   _____ Mastercard

           Name on Card:    ____________________________      Signature: ________________________________

           Card No:    ________________________________       Exp. Date: ________________________________

Membership Benefits Package:

With a charitable contribution of $25 or more you’ll receive all of these member benefits:

1.      A Membership Certificate suitable for proudly displaying your status as a “Dedicated Engineer.”

2.      A free subscription to DedicatedEngineers’ Newsletter (providing: current news, events, member/sponsor profiles, thought-provoking commentary and analysis, etc.).

3.      Eligibility in DedicatedEngineers’ Awards and Recognition Program (which recognizes outstanding individuals, including practicing engineers, college faculty, and students).

4.      Discounts on publications and other materials offered by or through DedicatedEngineers.

 PLUS:

1.      Donate $35 and you’ll receive an official DedicatedEngineers coffee mug – a perfect item to help get your day started off on the right foot, while also proudly displaying your status as a “Dedicated Engineer.”

2.      Donate $50 or more and you’ll receive an official DedicatedEngineers Multi-Function Tool (a handy, compact "13-in-1" tool providing: pliers, wire cutter, mini-saw, two screwdrivers, punch, ruler, two knives, hook remover, bottle opener, can piercer, and file) complete with its own carrying case - perfect for making those necessary "engineering adjustments" around the house, on the job, on the road - wherever/whenever needed!

Individual/Family Sponsorship:

 All charitable contributions of $100 (Bronze level) or above qualify the donor as an Individual/Family Sponsor of DedicatedEngineers.  Such donors receive special recognition as follows:

1.      A personalized thank-you item acknowledging your contribution (paperweight, plaque, etc).

2.      Online acknowledgement of your donation.

3.      Special recognition in DedicatedEngineers’ Newsletter.

4.      Special recognition in DedicatedEngineers’ Annual Yearbook and Member/Resource Directory.

5.      Complementary copies of DedicatedEngineers’ Annual Yearbook and Member/Resource Directory.