Please print the form below and mail it, with your check (made payable to the University of California Regents) to:

White Mountain Research Station
University of California
9500 Gilman Drive,
Dept. 0689
La Jolla, CA 92093-0689

Adopt-A-Log Adoption Form

I/we would like to adopt ____ "long" log(s) at $200, for a total of  ____.
____ "short" log(s) at $100, for a total of ____.

Donor’s Name(s):
________________________________________________________________________________

Address, City, State Zip:

________________________________________________________________________________

Name of adoptive parent(s) or organization to be inscribed on the log(s). Please limit inscription to 30 characters (letters, spaces and punctuation) per log:

  1. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
  2. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
  3. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
  4. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

Name of donor(s) to be inscribed on the brass plaque. Please limit to 30 characters (letters, spaces, and punctuation):

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

If your employer has a matching gift program, please enclose a matching gift form. Please make checks payable to the University of California Regents and mail to the address listed above.