Summary: THE UVAHS PROFESSIONAL NURSING STAFF ORGANIZATION
Contributing to the PNSO
Professional Development Fund for Nurses
Thank you very much for your contribution to the Nurses' Professional Development Fund! Your gift will help promote continued
excellence in nursing at UVA Health System! Please complete the information below and send to the
PNSO Support Office, Box 800135 (phone 924-8780). Be sure to retain a copy for your records.
Name ______________________________________________ Phone ________________________________
I wish to make a donation to the Professional Development Fund for Nurses in the amount of $_____________________.
Please, direct my gift to the Certification Fund for Nurses.
Signed, _____________________________________ Date_______________
PLEASE CHECK THE DONATION METHOD DESIRED:
I would like to make a donation as a lump-sum gift. Make check payable to University of Virginia Medical Center, write "PNSO
Professional Development Fund" in the memo and submit to the PNSO Support Office, Box 800135 (phone 924-8780).
I would like to make a donation via payroll deduction by using the form from the Development Office (below, with Fund
information filled in).
PLEASE CHECK THE DEDICATION DESIRED, IF ANY:
I would like for my donation to be in honor of ___________________________________________________________________
(name of person(s) being honored)
I would like that person to be notified of the donation. His/Her Address is: