Please Make a Donation Today

Designate my gift to (circle one):

* Programs & Services Funds

* Capital Expansion Funds

* Unrestricted Funds

Your gift can be matched if your spouse or partner works for a matching gift company.

All gifts are tax deductible
and all donors will be acknowledged in the Annual Report.

Thank you for your gift.

Please print this page and mail it to:

Annual Fund
Mattapan Community Health Center
1425 Blue Hill Avenue
Mattapan, MA 02126

Yes, I want to support Mattapan Community Health Center and its mission to improve the quality of life for residents of Mattapan and surrounding communities by providing comprehensive, accessible, affordable, and culturally appropriate community health care services, including primary and preventive health services.

Name:____________________________________________

Address:___________________________________________

City:______________________________________________

State:_____________________________________________

Zip Code:______________________________________________

Phone:____________________________________________

E-mail:____________________________________________

Fax:______________________________________________


I would like to support the Health Center at the following level (please circle one):

Patron - $1,000 or more

Sponsor - $500 - $999

Donor - $250 - 499

Contributor - $100 - $249

Friend - $10 - $99

Enclosed is my gift of $____________

I would like to pay by (please circle one):

 
MasterCard

Check

 



Account number: ___________________________________

Signature: ________________________________________

Exp. Date: ________________________________________