2008 Gilda Sponsor A Visit

Sponsor A Visit

All services provided at The Wellness Community are free of charge. However, it cost approximately $100 for every visit. With roughly 20,000 annual visits, every donation helps to ensure that our services will continue to be free for people with cancer, their families and caregivers.

Price $100

PLEASE COMPLETE THE FOLLOWING INFORMATION

Name Listing

I would like to sponsor the following number of visits:

The total amount of these visits (at $100/visit) is:

* required

Donor Information

First Name:

* required

Last Name:

* required

Company:

Address 1:

* required

Address 2:

City:

* required

State:

* required

Zip Code:

* required

Email:

* required

Phone:

Payment Information

PLEASE MAKE CHECKS PAYABLE TO

THE WELLNESS COMMUNITY-GREATER BOSTON
ATTENTION: SHANNA FULLER
1039 CHESTNUT STREET
NEWTON, MA 02464

OR COMPLETE THE CREDIT CARD INFORMATION BELOW

Credit Card Information

Cardholder Name:

* required

Card Number:

* required

Card Type:

Expiration:

* required

Address if different from above

Address:

City:

State:

Zip Code: