VCC Memorial / Honor Gifts

Many people derive great satisfaction by making gifts to the VCC in memory or in honor of someone. Such gifts express high regard for the individual being remembered or honored, and help support VCC research, treatment, and community outreach activities.

To make a memorial/honor gift, fill out this form, print it, and mail to the VCC.

Amy Gilman
Vermont Cancer Center
University of Vermont College of Medicine
The Courtyard at Given - Room N402
89 Beaumont Avenue
Burlington, VT 05405
Phone: (802) 656-8519

•Checks should be made payable to: Vermont Cancer Center.

•We also accept credit cards (MasterCard, Visa, AmEx, Discover).

Your donation to the VCC is tax deductible in accordance with IRS regulations.

About You
Salutation:
Your First Name:
Your Last Name:
Your Address:
Your City:
Your State or Province:
Your Zip Code:
Your Country:
Your Daytime Telephone:
How did you hear about us?
VCC newsletter:	Check this box if you would like to receive the free VCC newsletter. Please note, we do not share our mailing lists with other organizations.
Your Email Address:
Anonymous Gift:	VCC often recognizes major contributors in public to show our gratitude for their generosity. If this box is checked, your name will not be associated with your contribution.
Gift Information
I would like to make a gift of:	$10,000 $5,000 $1,000 $500 $250 $100 $50 $25 Other:
This Gift is Given:	In Honor of In Memory of Full Name: City: State/Prvnc:

Notification Card	The VCC will send a letter acknowledging your gift on behalf of the person you indicate below
Relationship:	Person being notified is the of the person being honored
First Name:
Last Name:
Address:
City:
State or Province:
Zip/Postal Code:
Country:

Credit Cards	If paying by credit card, please include the information below:
Credit Card:
Name as it appears on card:
Account #:
Expiration Date:	Month: Year:
Signature:

Thank you for your support!

Please print this form and mail to:

Amy Gilman
Vermont Cancer Center
The Courtyard at Given, Room N-402
89 Beaumont Avenue
Burlington, VT 05405

Giving

VCC Philanthropy 2008