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This form will not be transmitted electronically. To make a gift please complete, print and mail this form with your check or money order to the address listed below. If you are paying by credit card, you may fax the form to (212) 255-6754. Occupational and Industrial Orthopaedeic Center(OIOC) Hospital for Joint Diseases ATTN: Victor H. Frankel Occupational Orthopaedic Fund 63 Downing Street New York, NY 10014 |
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I have
enclosed a matching gift form from my employer.
Designation of Gift Unrestricted gifts enable the institution to direct funds to where they can make the greatest impact.
Please check here to make an unrestricted gift to the General Fund.
I would like to have my gift designated to:
Memorial or Tribute Gift: I would like to make this gift:
In honor of:
In memory of: Name: Occasion:
(e.g., birthday, anniversary, memorial, etc.) Please send an acknowledgment to (person or family): Name: Address1:
Address2: City:
State:
Zip: |