MLD Foundation - Thank You for Supporting Us!

DONATION – Step 1 of 2 ... You will be presented with a confirmation on the next screen.

Thank you for your tax deductible donation to MLD Foundation. Information on this form will only be used to properly receipt your donation and will never be sold, bartered or shared with any other organization.

If you wish to donate by paper check we request you fill in the following block and if desired, make a memorial/honor selection, then note the donor record ID on your check. Our mailing address and the donation ID will be supplied on the next screen.

About You:
First Name:		Last Name:
Email:	Email is optional ... but must be supplied to receive an electronic receipt from MLD Foundation

Donation amount: $

► Click here if you wish to make a Memorial or In-Honor-Of gift...

► Your gift is unrestricted, giving us the most flexibility to optimize its use. Click if you wish to restrict your gift to a specific purpose\t

► Click here if you wish to receive a paper receipt in addition to your electronic receipt ...

Please enter honoree's name.
First Name:	Last Name: Does/Did this person have MLD? Yes No
Send Acknowledgment to: (If you wish to have us notify the family of your gift (only that you gave, not the amount)
First Name:	Last Name:
Street:		City:
State/Provence:	Postal/ZIP:	Country:
Email (if known):
Phone (optional):