The Open Door Clinic, Inc.

The Open Door Clinic

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Donation Form

Join The Open Door Clinic, Inc. in its efforts to alleviate the effects of poverty in our communities. With your support, we can make a difference in the lives of many Chippewa County families and individuals who are unable to afford basic health care services.

I want to help!

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I would like to make a tax-deductible contribution to The Open Door Clinic, Inc.

My gift of $ __________ is enclosed.

Name:

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Organization:

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Address:

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City:

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State/Zip:

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Home Phone:

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Work Phone:

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Fax:

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E-mail:

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Thank you for your support!

 

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