1) Type of Contribution;

O Individual O Memorial To: _________________________ O Corporate Please attach the details for the acknowledgement to, Relationship to, and addresses.

2) Level of Contribution;

O Golden Circle ($10,000 and greater) O Research Partner ($5,000-$9,999) O Research Associate ($2,500-$4,999) O Research Major Donor ($250-$2,499) O Research Honor Roll Donor -Individual ($100-$249) O Research Honor Roll Donor – Corporate ($150-$249) O Research General Donor (Less then $100 Individual/$150 Corp.)

3) Method of Payment;

A) Attach Check (Payable to ASHRAE Research) Please note on check “Pittsburgh Chapter #24”

B) Credit Card O-Visa O-Master Card O-AMEX Date:________ Signature: ______________________ Card # : _________________________ Exp. Date: __________

Note: All contributions are fully deductible under section 170 of the IRS. 4) Donor Information:

Name: ________________________ Member # (If ASHRAE member):_________________ Corporation Name (If Corp. Donation): __________________________ Address: _______________________________

_______________________________ _______________________________

_______________________________ Phone : Home: _________________ Business: ___________________ E-Mail: _______________________________

5) Send the check and this completed form to:

Kurt A. Scheer - Resource Promotion Chairman

BDA Engineering, Inc.

19 35th Street Pittsburgh, PA 15201 412/682-3603 412/682-3605-Fax www.bdaengineering.com

Chapter may not act for Society Pittsburgh Chapter of ASHRAE Page 7 of 16