SETOR1-#5812683-v1-Gary_Nachsen_document.DOC
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PLEDGE FORM
in Memory of Professor Dr. Michael Milde
Name ___________________________________________________________________________
Address _________________________________________________________________________
City _______________ State/Province _______________ Postal Code _____________________
Telephone___________________________ Email_______________________________________
I wish to make a pledge to the
□ IASL – General Fund 02802, in memory of Professor Michael Milde
in the amount of (Canadian$)
□$100 □ $250 □ $500 □ other $_________
PAYMENT OPTIONS:
□ Cheque (made payable to McGill University).
□ Credit Card □Visa □MasterCard □American Express
Name on card__________________________________________________________________
Card number________________________________________Exp._______________________
Cardholder’s signature_______________________________________________________
Signature for pledge______________________________ Date________________________
□ WIRE TRANSFER PAYMENT TO:
|Beneficiary Bank: |Transit code: 00001 |Currency: Canadian $ |
|RBC Royal Bank of Canada |Swift code: ROYCCAT2 |Account name: |
|1 Place Ville Marie |Bank/Branch code: 003 |McGill University |
|Montreal, Quebec |McGill Bank Account Number: 308-101-5 |Please state: |
|H3C 3A9 Canada | |McGill IASL – Milde Fund |
Your pledge form can be sent or faxed to:
Maria D’Amico
Institute of Air and Space Law Association
McGill University
3690 Peel, Montréal QC Canada H3A 1W9
Fax: +1-514-398-8197
Email : maria.damico@mcgill.ca
Disclaimer: For security reasons, please do not sent your credit card information electronically via email, instant messaging, scanned document, etc). Please fax this form to (+1)-514-398-8197.
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5812683 v1
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