Foundation for Mitochondrial Medicine

July 31, 2010

What is it?

Make a Donation

Thank you for considering to donate. Your donations are tax deductible and very much appreciated.

Please use the form below to submit your donation securely online. This form will generate your receipt, allow you to specify what the donation is for, and where to send any acknowledgments.

If you wish to write a check, please make it out FMM and mail to Ste 238, One Dunwoody Pk, Atlanta, GA 30338. Please include a note if your donation is for an event, an item, or in honor/memory of a specific person. Also include whether you wish to be acknowledged for a donation and where to send (address or email) the acknowledgement. If you would prefer to save the foundation the cost of envelopes/mail, please include your email address and we will email your receipt to that location.

If you are considering a large donation, require more information, or wish to become involved with media outreach, please send an email to info@foundmm.org, and we will be in touch soon.

On behalf of all the families that your donation will touch, thank you.

CREDIT YOUR DONATION TO

Please credit my donation to one of the following:

General: For research and general operating expenses
In Honor Of : A donation in honor of a person
In Memory Of : A donation in memory of a person
Specific: Specific research initiatives

Amount:

$25
$50
$75

$100
$250
$500

Other Amount:

$ USD

Maximum online donation: $10,000
Please contact us for larger donation amounts.

Donor Information

Name:

Email:

In Honor Of

Name:

If you wish to be acknowledged for your donation, please enter where to send the acknowledgement below (email or address).
Address:
- OR -
Email:

In Memory Of

Name:

If you wish to be acknowledged for your donation, please enter where to send the acknowledgement below (email or address).
Address:
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Email:

Initiative:

If you wish to be acknowledged for your donation, please enter where to send the acknowledgement below (email or address).
Address:
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Email:

PLEASE COMPLETE THE FOLLOWING

CREDIT CARD INFORMATION

Type of Card:
* Card number:
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BILLING INFORMATION

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* First Name:
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* Phone:

Suite 238 . One Dunwoody Park, Atlanta, Georgia 30338. Tel 1-888-448-1495.