Black Physicians Network Diversity Fund

This fund was established to help support the organization’s mission and help disadvantaged minority youth pursue careers in medicine.

For your convenience, the Community Foundation accepts contributions using various methods. You can support the ongoing and emerging needs of the community now by using the form below to make a secure credit card donation (MasterCard, Visa, American Express).

All contributions are tax deductible to the full extent allowed by law.

Planning to give from an address outside the United States? Please email Gift Administrator Patricia Peters or call her at 585.341.4370.

Unique ID
1. Gift Amount
- Fund Name:
  Black Physicians Network Diversity Fund
  Want to donate to a different fund? Search here
- Donation Amount*
  
  Minimum $5 USD
2. Donor Information
Name*
First Last
Billing Address*
Street Address Address Line 2 City State ZIP Code
- Email*
- Phone*
3. Recognition Information
How would you like to be listed in our contributor report?*
- Same first name and last name as above
- I prefer to remain anonymous
- Use alternate name:
4. Honorary & Memorial Giving
Is this an honorary or memorial gift?*
- Yes
- No
Choose one of the following.*
- In honor of:
- In memory of:
Person being honored:*
Person being memorialized:*
(Optional) Please notify the following person of this memorial gift:
(Optional) Please notify the following person of this honor gift:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
- Email
- Phone
Additional Comments/Requests (If your employer is offering a matching gift, please be sure to include your company name here.)
How did you hear about the Community Foundation?
5. Donation Payment
Total
$0.00
Hidden
PayPal Fee
Hidden
Amount To Be Allocated

Black Physicians Network Diversity Fund

1. Gift Amount

2. Donor Information

3. Recognition Information

4. Honorary & Memorial Giving

5. Donation Payment