NEW YORK STATE SOCIETY OF RADIOLOGIC SCIENCES

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Your donation helps fund the student activities and student awards at the annual Fall Conference. The activities include but are not limited to: The Student Bowl, the essay contest and the poster contest.

Thank you in advance for your generosity.

sCHOLARSHIP fund dONATION

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Donation

* Mandatory fields

*First name

Middle Name

If you would like to add your Middle Name, you may do so. However, this is not a mandatory field.

*Last name

*E-mail

Please list the e-mail that you use most frequently. This will be the e-mail where important NYSSRS information will be sent. Students: Please do not use your school email.

*Phone

*Street Address

*City

*State

*ZIP Code

*Amount ($USD)

Dean's List Donors $50.00 (USD)

President's List Donors $25.00 (USD)

Gold Donors $20.00 (USD)

Silver Donor $15.00 (USD)

Bronze Donor $10.00 (USD)

Scholar Donor $5.00 (USD)

Please enter the amount you feel comfortable making to the Scholarship Fund. Your donation is most appreciated. Thank you

*Payment frequency

One-time

Annually

Comment

New York State Society of Radiologic Sciences

P.O. Box 302

Centereach, NY 11720-0302

NYSSRS, Inc. is a 501 (c) 6 non-profit organization

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