IMHO New Check Donation Form

Page 1

International
Medical
Health
Organization
 I.M.H.O.
 
 A
non‐political,
non‐profit,
humanitarian
organization
 
 A
501(c)(3)
registered
charity
in
USA

Donations
by
check

Name:_____________________________________________________________________________________________
 
 Address:
_________________________________________________________________________________________
 
 City:
______________________________________




State:
________________________





Zip:
______________
 
 Phone:
______________________________________




Email:
___________________________________________
 
 Comments:
 
 
 
 
 Please
make
checks
payable
to
“IMHO”
and
mail
your
donations
to:
 
 Rajam.
Theventhiran
 Treasurer
to
IMHO
 PO
BOX
61265,
 Staten
Island,
NY
10306
 U.S.A.

Sign
Up
Online!
 
 Use
your
credit
card
to
sign
up
online
through
our
secure
PayPal
system.

For
your
convenience
we
have
set
up
a
number
of
options
for
you
to
make
a
donation.

Please
visit
our
web
site
at
www.theimho.org
for
more
information.
 
 
 
 
 A
501(C)(3)
registered
charity
organization
in
USA
 Federal
Tax
ID
Number:
59‐3779465
 IMHO,
PO
Box
61265,
Staten
Island,
NY,
10306,
USA
 www.theimho.org


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