PRASAD CDHP One-Time Donation Form

Preferred title

First Name

Middle Initial

Last Name

Address

Address

City

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To offer your gift in honor / in memory of someone, complete the fields below

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Name / Occasion:

Please complete the following information specifying the person whom you wish to receive notification of your “in honor of” or “in memory of” gift.

Preferred title

First Name

Middle Initial

Last Name

Address

Address

City

State / Province

Country

Zip / Postal Code

Comments:

Payment Information

When you click continue you will be transferred to PayPal to complete your transaction.

PRASAD Children’s Dental Health Program Inc. is a 501 (c) (3) tax-exempt organization. Your contribution is tax deductible to the extent permitted by law. A copy of the latest audited report of PRASAD Children’s Dental Health Program Inc. can be obtained from our office or from the Office of the Attorney General by writing to The Charities Bureau, 120 Broadway, New York, NY 10271.

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