vcmcf-mail-in-donation-form2017

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I would like to donate: $1000 $500 $250 $100 $75 $

Please apply my gift:

Please receive my gift:

Wherever Most Needed

In Honor of

Research

In Memory of

Education Hospital Based Care Community Based Care

Send notification to:

Capital Projects

Monthly Quarterly Annually One-Time

Other ________________________

Payment Information My check is enclosed. Please charge my credit card

VISA

Discover

AMEX

Name

Card Number Exp.

MasterCard

Security Code

Address

Name on Card Authorized Signature

Phone Please make checks payable to:

Subscribe me to the Voices of Vellore e-newsletter.* email *We do not sell or share your information.

Please send me a copy of your Annual Report. Send me information on making a planned gift. I would like to remain anonymous in recognition material.

Vellore CMC Foundation, Inc. 475 Riverside Drive, Ste. 725 New York, NY 10115 1-800-875-6370 foundation@vellorecmc.org www.vellorecmc.org facebook.com/VelloreCMCFoundation @VCMCFoundation Pinterest.com/VelloreCMCFoundation

Contributions are 100% tax-deductible.


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