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Tree of Love - Donation Form

I would like to share the gift of health by pledging my support to the 2015 Tree of Love.

(Bolded fields are required.)

Please indicate below how your donation should be listed.

Street Address:
Postal Code:
E-mail Address:
Telephone #:
Donation Amount

Double or triple your gift for Genesys cancer patients if your company has a matching gift policy. If so, contact your human resources department for a matching gift form and send the completed and signed form to: Genesys Health Foundation, C/O Tree of Love, One Genesys Parkway, Grand Blanc, MI 48439. We will do the rest.

If you would like the acknowledgement of this donation sent to a different address than the one above, please provide that name and address here:

Credit Card Number:
Expiration Date:Card Type
Security code: (on back of card)

Visa,Mastercard, Discover, Amex

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