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Stewart R. Wallace — 1919–2009 - Society of Economic Geologists

Stewart R. Wallace — 1919–2009 - Society of Economic Geologists

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JULY 2009 No 78 SEG NEWSLETTER 11<br />

SOCIETY OF ECONOMIC GEOLOGISTS, INC.<br />

SOCIETY OF ECONOMIC GEOLOGISTS FOUNDATION, INC.<br />

7811 Shaffer Parkway Littleton, CO 80127-3732 USA Tel: +1.720.981.7882 Fax: +1.720.981.7874 E-mail: seg@segweb.org<br />

Contributions<br />

(This form may also be used by Companies, Institutions and Non-Members)<br />

Member Name ________________________________________________ ________________________________ ____________ Member No. ______________<br />

Last Name First Name Middle Initial<br />

Company / Institution ____________________________________________________________________________________________________________________<br />

Mailing Address � Home or � Business ________________________________________________________________________________________________<br />

City ________________________________________ State/Province ________________________ Postal Code ________________ Country____________________<br />

Phone______________________________________________________________ Fax_______________________________________________________________<br />

Email _________________________________________________________________________________________________________________________________<br />

CONTRIBUTIONS* (Please indicate your selection)<br />

� <strong>Society</strong> General Fund $_______________<br />

Foundation Funds<br />

� General Fund $_______________<br />

� Discovery Fund $_______________<br />

� Hugo T. Dummett Fund $_______________<br />

� Alberto Terrones L. Fund $_______________<br />

� Timothy Nutt Fund $_______________<br />

� Student Field Trip Fund $_______________<br />

� Hugh E. McKinstry Fund $_______________<br />

� Hickok-Radford Fund $_______________<br />

� Canada Foundation $_______________<br />

PAYMENT (US dollars only)<br />

TOTAL $ ____________________<br />

� VISA � MASTERCARD � AMEX � DISCOVER � CHECK (US Funds – Payable to S.E.G.) US $ _____________<br />

Card No. _______________________________________________________________ Card Security Code ____________________ Expiry Date_____________ /<br />

(3–4 digit code on back/front <strong>of</strong> credit card)<br />

Print Name as it appears on card _________________________________________________________________________________________________________<br />

Signature <strong>of</strong> Applicant _____________________________________________________________________________ Date_______________________________<br />

Please Mail or Fax to: +1.720.981.7874<br />

<strong>Society</strong> <strong>of</strong> <strong>Economic</strong> <strong>Geologists</strong>, 7811 Shaffer Parkway, Littleton, CO 80127-3732, USA<br />

*CONTRIBUTIONS: Income from invested contributions is used to support pr<strong>of</strong>essional activities <strong>of</strong> both organizations. The SEG and<br />

the SEG Foundation are tax-exempt 501(c)(3) corporations under U.S. IRS code. The SEG Canada Foundation is a charitable organization<br />

registered with the Canada Customs and Revenue Agency.

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