2003 ANS Student Conference at Berkeley

Online Sponsorship Form

Please fill out this form to determine the final amount of your support. After you have done so, you may use the button at the bottom of the form marked "Print Form" to print out the form for your records. Finally, use the button marked "Submit Form" to email your pledge of support to the conference organizers.

To complete your sponsorship, you may send funds by check or by credit card. For check payments, mail your payment and a copy of the completed form to:

American Nuclear Society
ATTN: Sponsorship
4101 Etcheverry Hall, MC #1730
Berkeley, CA 94720-1730

Checks should be made out to "ASUC / American Nuclear Society".

For credit card payments, use the button marked "Pay by Credit Card" at the bottom of the form. (You may also submit the form now and return to this page later to pay.)

You will be sent a confirmation email when your payment is received, and a formal letter containing
our non-profit tax ID will be sent if your gift is tax-deductible.

Individual / Organization Name (for our records):
Individual / Organization Name (as it should appear in the Program):
Name of Contact Person (Prefix, First, Last):
Contact's Title:
Contact's Mailing Address Line 1:
Contact's Mailing Address Line 2:
Contact's City:
Contact's State or Province:
Contact's Postal Code:
Contact's Country:
Contact's Email:
Contact's Daytime Phone Number w/Area Code:
Contact's Fax Number w/Area Code:

Item	Amount
Event Sponsorship Choose the event(s) you would like to sponsor or co-sponsor from the drop-down boxes below. If you wish to co-sponsor the event, edit the sponsorship amount in the column to the right to reflect the amount of your support.	$ $ $
Advertising Choose the type of advertisement you would like from the drop-down box below. If you have selected a half- or full-page ad, please tell us what type of resume book you would like: CD Printed Book If you have selected a full-page ad, please remember to register your representative.	$
Student Travel Enter the number of students you would like to support (at $200 per student) in the box below. You may then edit the amount in the column on the right if you wish. Number of Students	$
Donation Choose your desired donation level from the drop-down box below. If you wish, you may then edit the amount in the column to the right. Do you wish your donation level listed as "Passerby" (undisclosed amount)? Yes No (To have your donation level listed but not your name, enter "Anonymous" on the second line above, labeled "Individual / Organization Name (as it should appear in the Program)".)	$
Total Sponsorship Amount	$

Please enter any additional comments or instructions in the text box below:

Now press the button marked "Submit Form" to send your information to us.
You will be given a new window with confirmation that your information was submitted,
but your form information will remain open in this window.

PAYMENT METHODS

To send funds by check:
If you are paying by check, press the "Print Form" button below so that you may include
the printout with your check.

To send funds by credit card:
Payment by credit card is handled by PayPal, a reliable and secure money-transfer website.
If you have not previously used PayPal, you will be asked to sign up as part of the payment
process. Signing up with PayPal is completely free, allows you to send a payment to anyone
with an email address, and carries no charges for sending money. You will be sent an itemized
receipt by email for your records. If you are not comfortable using PayPal to pay your
sponsorship amount, please pay by check instead.

Click on this button to pay your total support using PayPal.