For donations up to $2,500.00, please fill out the form below. For donations of $2,500.00 or more, please contact the office by calling 414-389-8615 or send a check to SCAF, 6737 W. Washington St., Ste. 4210, Milwaukee, WI 53214. If you would like to make a stock gift, a planned gift or you would like to include the SCA Foundation in your will, please contact the Foundation office. Thank you for your support.

Personal Information

First Name (required)

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Designation Information

 I want my gift to go where it is most needed. I would like to support the SCA Foundation in the following endeavors:


 FOCUS on Reducing Human Error

 STS Database Project

 Patient Safety Endowment


 Annual Research Grant

 Roizen/Anes. Res. Fund SCA Starter Grant

 Endowed Research Fund


 General Education Operating Fund

 Earl Wynands Lecture Fund

 Kaplan Fellows Program

 Educational Endowment Fund

All designated gifts will include a 5% donation to the annual fund to cover administrative costs.

Honor A Mentor/In Memorial

Please list my gift or pledge as given  In Honor Of A Mentor In Memory Of

If you would like to Honor more than one Mentor, please contact the SCA Foundation office at 414-389-8615 or

Gift Made In Honor/ In Memory Of: Enter Name and Address Below

Honor or Memory of name


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