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Foundation - Online donation form

Thank you for supporting the AMA Foundation. Your generosity enables the Foundation to provide critical support for public health, medical education and research.

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*Please accept my gift of:
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Other   $
  One-time gift
  Monthly gift for months. (Total gift will be divided up over x number of months)
  Quarterly gift for quarters. (Total gift will be divided up over x number of quarters)

Please apply my gift to the following program

(choose one):
Physicians of Tomorrow           
Minority Scholars Awards
Arthur N. Wilson, MD, Scholarship        
The Scholars Fund
     Designate Scholars Fund amount to:
     
Healthy Communities/Healthy America
Fund for Better Health  
Health Literacy
Health Care Recovery Fund   
Excellence in Medicine Awards  
Seed Grant Research Program  
National and Regional Student Research Forums
Future of Medicine (unrestricted support)
WorldScopes

Your information

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Yes, I would like to receive additional information via e-mail.

Yes, I would like to receive additional information about the Ronald P. Bangasser, MD, Legacy Society.

Many employers match donations made to education. If yours does, your gift can be doubled at no additional cost to you. Please check with your human resources department to see if your employer has a matching gift program.

Matching employer:

Yes, I would like to remain anonymous.

 

Credit card information:

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Billing Information: (If same as above check here: )
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Yes, I am a member of the AMA Alliance

Yes, I would like to dedicate my donation to a specific individual.

Yes, notify the individual of the donation by U.S. mail.

In honor of

In memory of

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Last updated: Nov 12, 2008
Content provided by: AMA Foundation