January 2004 - History of Science Society

History of Science Society Newsletter January 2004
A request to support the History of Science Society
I am pleased to contribute __$25 __ $50 __ $100 __ $250 __ $500 __$1000* __ Other ___ to
(*Please note: for gifts of $1000 or above, a donor transmittal letter is required. See page 3.)
___ the Bibliographer’s Fund (every dollar contributed goes toward meeting a challenge grant from the NEH) (see story on page 1)
___ the Hazen matching fund for education in the history of science (every dollar contributed goes toward meeting a challenge
grant from the Hazen family)
___ the general endowment fund
Please make all checks payable to the History of Science Society and return with this form to:
History of Science Society
University of Florida
P.O. Box 117360
Gainesville, FL 32611-7360
You may also charge a gift. Please select one of the following options:
__Visa __ MasterCard __American Express __Discover
Account #
Card verification value (last 3 digits on the back signature panel for V/MC, 3 or 4 digits on the front of AmEx.)
Expiration Date
Name of Account Holder
Signature
Phone
Account Billing Address:
HSS
receives
NEH
Challenge
Grant
(See story page 1)
The University of Chicago Press
P.O. Box 37005
Chicago, IL 60637
Forwarding Service Requested
NONPROFIT
U.S. POSTAGE
PAID
CHICAGO, IL
PERMIT No. 6784