Donate By Mail

Donate By Mail

 

 
  • Donate By Mail
Home » Donate Now » Other Ways to Support PRF » Donate By Mail

If you would like to mail in your tax deductible donation, please print this form and send a check or money order to:

The Progeria Research Foundation, Inc.
P.O. Box 3453
Peabody, MA 01961-3453

ENCLOSED IS MY CONTRIBUTION FOR:
$2500 $1000 $500 $250 $100 $50 $25
Other

Optional:
In Memory of:

In Honor of:

CONTRIBUTOR INFORMATION
Name:

Address:

City:

State:

Zip Code:

E-mail Address:

Phone Number:

PLEASE ACKNOWLEDGE MY GIFT TO:

Optional:
If this is a gift in memory or in honor of someone and you would like to inform a third party of your gift, please provide the following information about them:
Name:

Address:

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State:

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Please tell us any other information we may need concerning this gift:

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