If you would like to mail in your donation you can print this form and mail it in for your tax deductible donation. Please send check or money order to:
The Progeria Research Foundation, Inc.
P.O. Box 3453
Peabody, MA 01961-3453
ENCLOSED IS MY CONTRIBUTION FOR:
$500 $100 $50 $25
Other
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In Memory of:
In Honor of:
CONTRIBUTOR INFORMATION
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PLEASE ACKNOWLEDGE MY GIFT TO:
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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:
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Gift Cards
Donate to PRF and we will send a card in your name to a friend or loved one:
Examples of Types of Cards:
Congratulations!
Get Well
In Remembrance
Season's Greetings
Thank You
Other
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