Foundation Donation Form

SEPM Foundation Funds


To make a donation to a specific fund please indicate your choice below. More information on each Fund can be found at the List of Funds

General Fund
Harleton Fund
Grover and Sally Murray Educational Endowment
Ken Hsu Endowment
Robert J. and Ruth A. Weimer Grant Fund
John E. Sanders Grant Fund
Gerald M. Friedman Fund
Garry Jones and Brian O'Neill Memorial Fund for NAMS Student Research
Medal Funds (Twenhofel Medal, Shepard Medal, Moore Medal, Pettijohn Medal, or Wilson Medal)

 Arnold and Lieneke Bouma Fund

Comments or Instructions: (Example - Donation made to the Student Fund in Brian O'Neill's name)

Personal Details


Required fields marked with a *
Contact Information
First Name:  *
Last Name:  *
Member Number:
Phone:  *
Email:  *
Billing Address
Address:  *
City:  *
State/Provice:  *
Zip Code:  *
Credit Card Information
Type:  *
Credit Card Number:  *
Expiration:  /   *
Security Code:  *What is this?
Total amount to charge:  *

Please contact Theresa Scott at if you have any questions.