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International Medical Health Organization I.M.H.O. A non‐political, non‐profit, humanitarian organization A 501(c)(3) registered charity in USA Donations by check Name:_____________________________________________________________________________________________ Address: _________________________________________________________________________________________ City: ______________________________________ State: ________________________ Zip: ______________ Phone: ______________________________________ Email: ___________________________________________ Comments: Please make checks payable to “IMHO” and mail your donations to: Rajam. Theventhiran Treasurer to IMHO 955 Proprietors Road, Suite B Worthington, OH 43085 U.S.A. Sign Up Online! Use your credit card to sign up online through our secure PayPal system. For your convenience we have set up a number of options for you to make a donation. Please visit our web site at www.theimho.org for more information. A 501(C)(3) registered charity organization in USA Federal Tax ID Number: 59‐3779465 www.TheIMHO.org Tel: 347.601.1364; Fax: 718.554.1723 Email: [email protected]

IMHO Check Donation Form

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Page 1: IMHO Check Donation Form

InternationalMedicalHealthOrganizationI.M.H.O.

Anon‐political,non‐profit,humanitarianorganization

A501(c)(3)registeredcharityinUSA

DonationsbycheckName:_____________________________________________________________________________________________Address:_________________________________________________________________________________________City:______________________________________State:________________________Zip:______________Phone:______________________________________Email:___________________________________________Comments:

Pleasemakecheckspayableto“IMHO”andmailyourdonationsto:

Rajam.TheventhiranTreasurertoIMHO

955ProprietorsRoad,SuiteBWorthington,OH43085

U.S.A.

SignUpOnline!

UseyourcreditcardtosignuponlinethroughoursecurePayPalsystem.

Foryourconveniencewehavesetupanumberofoptionsforyoutomakeadonation.

Pleasevisitourwebsiteatwww.theimho.orgformoreinformation.

A501(C)(3)registeredcharityorganizationinUSAFederalTaxIDNumber:59‐3779465

www.TheIMHO.org

Tel: 347.601.1364; Fax: 718.554.1723 Email: [email protected]