Foundation Donation Form

Donation

Contributions help the NCAFP Foundation realize better health for all North Carolinians. To contribute, please complete the following form and follow all instructions. For immediate questions, please contact Tracie Hazelett at the NCAFP Foundation at 919-980-5357.

Donation
Donation Type *

Donor Information

Address *
Address
City
State/Province
Zip/Postal

Select How Your Contribution Is To Be Used

Direct Gift

Select Payment Method *

Personal Info

Credit Card Info (This is a secure SSL encrypted payment.) *
Credit Card Info (This is a secure SSL encrypted payment.)
In order to complete your offline donation we ask that you please follow these instructions:

1. Make a check payable to "NC Academy of Family Physicians Foundation"
2. On the memo line of the check, please indicate that the donation is for "NCAFP Foundation"
3. Please mail your check to:
NC Academy of Family Physicians Foundation
2501 Blue Ridge Road, Suite 120
Raleigh, NC 27607.

All contributions will be gratefully acknowledged and are tax deductible. If you have any questions, please contact Tracie Hazelett at the NCAFP Foundation at 919-980-5357.

Thank you.