Devers Eye Institute Giving
Donation Form
Donation Information
Amount:
$25,000.00
$10,000.00
$5,000.00
$1,000.00
$500.00
$250.00
$100.00
$50.00
Other
$
*
Designation:
Devers General Fund
Devers Indigent Fund
Jack Cioffi Fellowship Fund
Mark A. Terry, M.D. Endowment for Corneal Care
Van Buskirk Research Chair Endowment
Additional Information
Type of gift:
One-time gift
Recurring gift
Frequency:
Weekly
Monthly
Quarterly
Annually
Every 4 weeks
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Anonymous:
I prefer to make this donation anonymously
Comments:
This gift is in honor/memory of (Optional)
Type:
In honor of
In memory of
*
Name:
*
First name:
Last name:
*
Please send a donation acknowledgement to the honoree on my behalf
*
// ]]>