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THANK YOU

for your support of Faith Family Medical Center. Your donation will help Faith Family continue its mission of offering hope and medical care to the working uninsured and other underserved by meeting their physical, emotional, and spiritual needs.

Donation Form

Donation Amount:

I would like my donation to recur (monthly, quarterly, semi-annually, annually, etc.):

Yes

Amount you would like to recur:

Frequency of donation:

Number of recurrences:

Date of your final recurring donation:

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Please confirm recurring donation:

Please help us maxmize your gift by adding the credit card processing fee to your gift (3.95%):

$0.00

Total:

$0.00

This gift is also from:

I would like to donate anonymously:

Yes

Please use my gift:

to support the mission of Faith Family Medical Center

as a Capital Campaign gift

as a Birthday Breakfast Sponsorship

This donation is in honor of:

This donation is in memory of:

*NOTE* If your Donation is in Honor of or In Memory of someone, please provide the name and full address of the person(s) to whom we should send a notification letter:

I would like to be placed on your email list:

Yes

How did you hear about us:*

Social Media

A Friend

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Other

If other, please specify:

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