Yes! I want to support MTSA.

Thank you for your support of the Middle Tennessee School of Anesthesia. Your tax deductible gift can be made online through a secure connection by completing the following form. You too may make your gift by check. Simply printout and complete the form below and send it with your contribution to: Middle Tennessee School of Anesthesia, P.O. Box 417, Madison, TN 37116, or contact Jim Closser at 615-732-7674.

Please apply my gift to the following program(s):

Bernard V. Bowen Society Member: Your Membership Gift honors the life and legacy of MTSA Founder Dr. Bernard V. Bowen.

  • $10,000 - Bowen Society Lifetime Member (Recognized with certificate and Medallion in pedestal)
  • $1,000 - Bowen Society Annual Member (Recognized with certificate followed by Medallion after five years consecutive membership)
  • $100 - Bowen Society Student Member (Recognized with certificate. This level is for MTSA students only)

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MTSA Annual Fund Membership:
This program provides unrestricted ongoing annual support for a variety of projects and programs ($100 to $249 Ambassador; $250 to $499 Pacesetter; $500 to $999 Benefactor).

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MTSA Golf Classic:
This annual event, sponsored by Anesthesia Medical Group, P.C., is held in September at Hermitage Golf Course, Hermitage, Tennessee. The unrestricted proceeds will be used to fund MTSA projects and programs.

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Please indicate your level of support:
$175 per player
$150 per hole sponsor
$700 per team
$850 for foursome and hole sponsor
Other

Alumni Scholarship Fund:
Your contribution to the Alumni Scholarship fund permits the alumni committee to award needed scholarships.

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Endowment Fund:
Earnings from the endowment helps fund a variety of MTSA needs.

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Wills/Bequest:
Your consideration in remembering MTSA in your estate plan is a wonderful way to leave a lasting legacy. You may do this through a will, trust, annuity, bequest or other planned gift. Please mark this section if you have done this, plan to do so, or would like us to contact you.

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Other:

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Optional:
I would like my gift to be (please check one):

In memory of:
In honor of:

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