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Thank you for your consideration of support for the University of Maryland Medical System Foundation. Your contribution enables the University of Maryland Medical Center to remain at the forefront of patient care, discovery and education.

You may contribute to up to two programs using this form. If the fund you are looking for is not in the drop-down menu, please check the "Other" box below and view a complete listing of funds . If you prefer to make a gift by mail, please complete and include this PDF donation form with your contribution.

Still have questions? Please call us at 410-328-5770.

Please select:

Amount

Other--I would like to designate my gift to another fund or department.

Fund Name:

Amount:

Note (optional):

Total Gift: 0.00

Tribute Gifts

I'd like this to be a tribute gift.

Tribute Gift Type:

Honoree Title:

Honoree First Name:

Honoree Last Name:

Send a Notification of Your Gift

Sending an eCard (electronic card) by email is a great way to tell family and friends about this gift. Once your gift is processed, your eCard will be emailed automatically on the date you select below.

Yes, I would like to send an eCard.

Send eCard on:Select month of credit card Select Expiration Year

Recipient Email Addresses:

Select an eCard: (tribute gift, gift in celebration, all-occasion)

eCard Subject:

Message:

Yes, send me a copy of the eCard.

Honor Gift Notification

If you would like us to mail your designated party that a gift has been made in his/her honor, or to notify a family of a memorial gift, tell us to whom the notification should be sent and the address

(Required) Name of Individual to notify about my gift:

(Required) Individual's Street Address:

Individual's Apartment/Box/Unit/Suite:

(Required) Individual's City:

(Required) Individual's State:

(Required) Individual's ZIP/Postal Code:

Donor Information

Donor Title:

Donor First Name:

Donor Middle Name:

Donor Last Name:

Donor Suffix:

Donor Professional Suffix:

Donor Street 1:

Donor Street 2:

Donor City:

Donor State/Province:

Donor ZIP/Postal code:

Donor Country:

Donor Phone Number:

Donor Phone Type:

Donor Occupation:

Donor Employer:

Donor Email Address:

Yes, I would like to receive e-communications from UMMS Foundation.

Matching Gifts

Search our online database to see if your company/organization has a matching gift program.
Learn more about matching gifts.

Billing Information

Please use my mailing address above as my billing address.

Billing Title:

Billing First Name:

Billing Middle Name:

Billing Last Name:

Billing Suffix:

Billing Street 1:

Billing Street 2:

Billing City:

Billing State/Province:

Billing ZIP/Postal Code:

Billing Country:

Remember Me

Payment Information

Payment Method:

Credit CardChecking Account

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Checking Account Information:

Bank Routing Number: What is this?

Bank Account Number:

Verify Bank Account Number:

Account Type:

Checking
Savings

By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.

Make a Gift

Please select:

Tribute Gifts

Send a Notification of Your Gift

Donor Information

Matching Gifts

Billing Information

Payment Information

Payment Method:

Credit Card Information:

Checking Account Information:

Check Information