Pledge Card - Safar Center for Resuscitation Research

SAFAR CENTER FOR RESUSCITATION RESEARCH
UNIVERSITY OF PITTSBURGH
Thank you for your
generous support in
contributing to the legacy
of Peter Safar, M.D.
Safar Center for Resuscitation Research
University of Pittsburgh
Attn: Fran Mistrick
3434 Fifth Avenue
Pittsburgh, PA 15260
Telephone:
412 - 383 - 1900
E-mail:
[email protected]
l
SCHOOL OF MEDICINE
Peter Safar Legacy Fund
Supports clinical and laboratory research in the areas of cardiac
arrest, traumatic brain injury, hemorrhagic shock, emergency
hypothermia, pediatric neurointensive care and resuscitation,
child abuse, and rehabilitation.
The Nancy Caroline Fellow Award
Supports research by trainees in honor of Dr. Nancy Caroline,
one of Dr. Safar’s first students and the mother of emergency
medicine in the country of Israel.
The Annual Safar Symposium at the University of Pittsburgh
A symposium held each fall on the campus of the University of
Pittsburgh in honor of Dr. Safar. The symposium brings together
physicians and scientists from around the world to discuss new
breakthroughs in resuscitation along with the use of simulation to
train health care professionals and lay persons in resuscitation
and other related techniques.
(over)
PETER’S LAW #22: “It’s up to us to save the world.”
SAFAR CENTER FOR RESUSCITATION RESEARCH
UNIVERSITY OF PITTSBURGH l SCHOOL OF MEDICINE
Name _______________________________________
(Name)
If Joint Gift ____________________________________
(Name of Spouse)
I’M PROUD TO MAKE A TAX DEDUCTIBLE GIFT/PLEDGE OF:
$100
$500
$1,000
$2,500
$ ____________________
For a pledge, please send reminder notices in ______________________
All pledges require donorÕs signature.
Month(s)
Home Address ________________________________
_____________________________________________
Home Telephone ( ______ ) ______________________
PLEASE DIRECT MY GIFT/PLEDGE TO (details on reverse):
$ ____________ Peter Safar Legacy Fund (SAFAC)
Donor(s) Signature(s): __________________________
$ ____________ The Nancy Caroline Fellow Award (NCARO)
_____________________________________________
$ ____________ The Annual Safar Symposium at the
University of Pittsburgh (SAFSY)
I/We _____ grant _____ do not grant permission for the
University of Pittsburgh to use my/our names(s) in
campaign promotion material, including news releases.
PREFERRED PAYMENT OPTIONS:
 Check: Please make payable to University of Pittsburgh, SCRR
 Credit Card:  Visa  MasterCard  Discover  American Express
American Express will be accepted for any gift of $25 - $25,000
I/We wish to have my/our name(s) appear on the
University of Pittsburgh Honor Roll of Donors as follows:
_____________________________________________
Account # ____________________________________________________
Expiration Date ________________________________________________
Signature _____________________________________________________