SIU School of Medicine

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Department of Medical Humanities

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FRIENDS OF THE PEARSON MUSEUM

Friends of the Pearson Museum receive invitations to special events, lectures, and receptions. Contributions are recognized in the School of Medicine Honor Roll, published each year by the Southern Illinois University Foundation. All membership contributions are fully tax-deductible.

Department of Medical Humanities

The Pearson Museum

Ross D. Silverman, J.D., M.P.H., Chair, Department of Medical Humanities
Phillip V. Davis, Ph.D., Museum Director

For more information about the Pearson Museum or the Friends, call 217.545.8017, email Dr. Davis, or write:

The Pearson Museum
Southern Illinois University
School of Medicine
P.O. Box 19635
Springfield, IL 62794-9635

MEMBERSHIP ENROLLMENT FORM

I wish to support the Friends of the Pearson Museum at the level indicated below:

Benefactor ($1,000)____________________

Sponsor ($500)_______________________

Patron (150)__________________________

Friend ($50)__________________________

Other Gift ___________________________

Name  
Address  
   
City  
State  
ZIP/Postal Code  

Please omit my name from publication. __________ (Please check and initial)

Print out the form and mail to the address below. 

Please return this form, along with your gift. CHECKS SHOULD BE MADE PAYABLE TO THE SIU FOUNDATION--Friends of the Pearson Museum. Thank you for joining us!

SIU Foundation--Friends of the Pearson Museum
SIU School of Medicine
P.O. Box 19666
Springfield, IL 62794-9666