Online Giving - UMass Medical School
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UMass Memorial Foundation

Thank you for investing in the University of Massachusetts Medical School and UMass Memorial Health Care.

Make a Gift Now
Annual Research Fund/Worcester
    Foundation for Biomedical Research
Annual Medical Education Fund
Annual Patient Care Fund Where it is needed most
Other
(If you choose more than one area, your gift will be divided equally unless you instruct otherwise in comment section below.)
Comments:
Your information:
Title:
*First Name:
Middle Name:
*Last Name:
Company Name:(if gift is from business)
Check this box if using your company address.
*Mailing Address 1:
Mailing Address 2:
*City/State/Zip:
*Country:
*Telephone: Fax:
*e-mail Address:
*Confirm e-mail Address:
What best describes your Affiliation :
How did you find our site?    
I would like to make a gift or pledge of:
$2,500 $1,000 Choose your contribution payment schedule:

 Charge my card in full for my gift.

 Charge my card monthly for the selected amount for
      consecutive months.

 Charge my card quarterly for the selected amount
     for 4 quarterly payments.
$500 $100
$50 $25
Other
$
(Note: $25.00 minimum)
I'm interested in learning more about:
Emergency and Trauma Cancer
Medical Research Diabetes
Educating Health Professionals Children's Medical Center
Arthritis and Orthopedics Heart and Vascular Wellness
The Brain and Nervous System HIV/AIDS Research
Patient Care and Treatment Estate Planning
Please specify other special area(s) of interest.
Comments:
See how far your gift can go:
You can enhance your gift if you work for a company that has a matching gift plan. Please contact your Human Resources department for a matching gift form and mail your completed form to UMass Memorial Foundation, One Biotech, 365 Plantation Street, Suite 100, Worcester, MA 01605.

This gift will be matched by the matching gift program of my/my spouse's company.
Company Name:
Employee Name:
List of some companies with matching gift plan. Click herePDF file icon

If you would like to make your gift in memory or in honor of someone special:
In Memory In Honor Not Applicable
Name
Please let the individual listed below know of this gift (gift amount will not be disclosed):
First Name:
Middle Name:
Last Name:
Mailing Address 1:
Mailing Address 2:
City/State/Zip:
Country
Telephone: Fax:
e-mail Address:
Spouse/Partner information
Please provide this information if you would like to make a joint gift
First Name:
Middle Name:
Last Name:

Thank you for providing this information.

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