Donation Form - March Of Dimes Page 2
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2Donation in memory/ in honor
This gift is:
In memory
Remember someone special by giving a gift in their memory. March of Dimes will
send a card acknowledging your thoughtful donation to the person of your choice.
In honor
Give a gift to honor someone close to you for a birthday, an anniversary, a wedding,
to celebrate a birth of baby, or other special occasion. March of Dimes will send a
card acknowledging your thoughtful donation to the person of your choice.
Who is this donation in memory/honor of:
Name ______________________________________________________________________
Occasion (in honor donations) ___________________________________________________
Please send an acknowledgement of my donation to:
First Name ____________________________ Last Name ____________________________
Address _____________________________________________________________________
City _________________________________ State _________________________ _ _______
Zip Code _____________________________ Country _______________________________
Phone _______________________________ E-Mail ___________________________ _ _____
code – 3IN
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