Planetary Studies Foundation

To become a member of the Planetary Studies Foundation, a non-profit educational organization:

1. Print this page.
2. Fill out the form.
3. Mail the completed form along with your check to the address provided below.

Adopt-A-Meteorite Form

Yes, I want to help preserve the James M. DuPont Meteorite Collection. Please accept my tax deductible
(US residents only) contribution to adopt one or more meteorites as follows:

 

Amount

Meteorite Classification
 

$ 2,500.00
$ 1,000.00
$ 750.00
$ 500.00
$ 250.00

SNC Meteorite (SNC meteorites are thought to be pieces of Mars)
Achondrite/Carbonaceous Chondrite Meteorite
Stony-iron Meteorite
Stone Meteorite
Iron Meteorite

 

Enclosed is my check for US funds made payable to the Planetary Studies Foundation in
the amount of $________________.  I understand that the meteorite(s) I adopt will be placed on
display along with a placard identifying the sponsor. I would like the name on the placard(s) to read as follows:

______________________________________________________________________

I understand that I will also receive a certificate identifying the above named person(s) or organization
as an adoptive parent in the Adopt-A-Meteorite program. This certificate will also describe the
meteorite that has been adopted.

 

PLEASE PRINT

Name: ______________________________________________________________

Address:_____________________________________________________________

____________________________________________________________________

City: ________________________________________________________________

State: ____________________________ ZIP:_______________________________

Phone: ______________________________________________________________

Email Address: ________________________________________________________


PLEASE MAIL TO:
Planetary Studies Foundation
10 Winterwood Lane, Unit B
Galena, IL 61036