Date: ______________________

Enclosed please find my contribution to SEDS-USA in the amount of $_________.
I understand that a receipt and acknowledgement will be mailed to me at the
address below.

___________________________     __________________________________________
Name (please print)             Street Address

___________________________     _____   __________________
City                            State   ZIP Code

Phone: (_____)______-________

Please return this form and your contribution to:

SEDS-USA, MIT Room W20-445, 77 Massachusetts Avenue, Cambridge, MA 02139

Disclosure Statements:
        SEDS is recognized by the Internal Revenue Service as a non-profit 
501(c)(3) organization.  In most cases, your contribution will be 
tax-deductible.  Further details will arrive in your acknowledgement letter 
from SEDS-USA, but we suggest you consult your tax advisor before claiming this 
contribution as a deduction.
        A copy of our current financial statement is available upon request.  
Please send requests to the above address.  
        If you have further questions about the programs which will be 
supported by your contribution, please do not hesitate to contact us at the 
above address, or via email.