PRINTABLE FORM FOR MAILING

YES, I want to give to the Harry Benford Fund!

NAME ______________________________________________________________________

ORGANIZATION (if applicable) _________________________________________________

ADDRESS ___________________________________________________________________

_____________________________________________________________________________

TELEPHONE ___________________________ FAX _______________________________

EMAIL ADDRESS_____________________________________________________________

********** SUGGESTED LEVELS OF GIVING **********

_____	$10,000	_____	$2,000
_____	$7,500	_____	$1,500
_____	$5,000	_____	$1,000
_____	$2,500	_____	$500
$ _________ Other amount

Please make checks payable to the University of Michigan and send to:
Kay Drake
University of Michigan, Dept of NA & ME
2600 Draper Drive
Ann Arbor, MI 48109-2145