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SAGES Education & Research Foundation
11300 West Olympic Blvd.
Suite 600
Los Angeles, CA 90064
Phone: 310.437.0544 x 114
Fax: 310.437.0585
E-mail: foundation@sages.org

Copyright 2007 Society of American Gastrointestinal and Endoscopic Surgeons

SAGES Foundation Giving Levels:

You may also download this form as a PDF file. To make a one-time direct contribution, select "1" for the duration of the pledge below. You may also select a custom amount to donate if you do not wish to give at a level. All donations are welcome.

Level of Participation	Pledge or Contribution	Benefits:
Legacy Benefactor	$1,000.00 or more per year until retirement (This requires a 10 year commitment)	Acknowledgment of participation as a Legacy Benefactor in Foundation Newsletter Acknowledgment on Foundation website Recognition in SAGES’ Mini-Scope e-newsletter Acknowledgment in Foundation Annual Report Complimentary tickets to select Foundation events Use of Donor’s Lounge at SAGES Meetings Legacy Benefactor pin
Diamond Patron	$10,000	Acknowledgment of participation as a Diamond Patron in Foundation Newsletter Acknowledgment on Foundation website Recognition in SAGES’ Mini-Scope e-newsletter Acknowledgment in Foundation Annual Report Complimentary tickets to select Foundation events Use of Donor’s Lounge at SAGES Meetings Diamond Patron Pin
Benefactor	$5,000	Acknowledgment of participation as a Benefactor in Foundation Newsletter Acknowledgment on Foundation website Recognition in SAGES’ Mini-Scope e-newsletter Acknowledgment in Foundation Annual Report Use of Donor’s Lounge at SAGES Meetings Benefactor Pin
Donor	$3,000	Acknowledgment of participation as a Donor in Foundation Newsletter Acknowledgment on Foundation website Recognition in SAGES’ Mini-Scope e-newsletter Acknowledgment in Foundation Annual Report Use of Donor’s Lounge at SAGES Meetings
Friend	$1,000	Acknowledgment of participation as a Friend in Foundation Newsletter Acknowledgment on Foundation website Acknowledgment in Foundation Annual Report Use of Donor’s Lounge at SAGES Meetings
Supporter	$500	Acknowledgment of participation as a Supporter in Foundation Newsletter Acknowledgment in Foundation Annual Report
Other/Direct Contribution (please indicate amount on the right)
I will fulfill my commitment in 5 years 4 years 3 years 2 years 1 year select "1 year" for direct gift

"I believe in our legacy to Endoscopic Surgery and want to support the vision and goals of the SAGES Education & Research Foundation. Please accept my contribution as outlined below."

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Payment Information

Please charge my 1st year’s pledge or my contribution to:
Card Number:
Expiration Date:	Month 01 [January] 02 [February] 03 [March] 04 [April] 05 [May] 06 [June] 07 [July] 08 [August] 09 [September] 10 [October] 11 [November] 12 [December]	Year 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

The SAGES Education and Research Foundation is a 501(c)(3) nonprofit. Contributions are fully tax-deductible to the extent allowed by law. Please consult your accountant for details.