Mail-in Donation Form

Mail-in Donation Form

Print this form, fill it out and mail to:

The Rosalind Martin-Handsome Lung Cancer Foundation

P.O. Box 24554

Denver, Colorado 80224

Donor Information:

Name:___________________________________________

Address:_________________________________________

City:________________________________________ State:_______ Zip:____________________

Phone:___________________________________________

Email:____________________________________________

Donation Information:

Amount: $________________ Donor's Signature:_____________________________________

Please make check payable to: Rosalind Martin-Handsome Lung Cancer Foundation.

If you would like to make a donation in memory of or in honor of someone, please complete the following:

In Memory of:_____________________________________

In Honor of:_______________________________________

Please let us know who we should notify regarding the above memorial or honorarium:

Name:___________________________________________

Address:_________________________________________

City:________________________________________ State:_______ Zip:____________________

Phone:___________________________________________

Email:____________________________________________

If you have any questions, please email us at donations@martin-handsome.org

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"We thank you for your donation and support."

Mail-in Donation Form - version 02 dtd 11/17/06