Floating Doctors Donation

NOTE: Are you contributing to a volunteer's pledge?  Please give through the link HERE.
 
 

Gift Information

Donation Amount*
  • $25
  • $50
  • $100
  • $150
  • $200
  • Other $
Honoree's Name

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Floating Doctors' intent is to use all designated gifts for the specific purposes and projects designated.  In exceptional circumstances where the designated purposes are not longer feasible or have been completed, Floating Doctors may redirect such gifts to other appropriate programs or projects.  Under such circumstances, Floating Doctors Executive and Program Directors will, to the extent deemed feasible, retain the basic original purpose of the donation.

 
 

Payment Information

Amount*
$
Name on Card*
Card Number*

Share This Form

Powered by eTapestry.