FHCCM - Family Health Care Centers of Manatee Foundation

[Pledge Form]

Foundation Benefactors
I pledge to become a:
Sustaining Benefactor $50,000 Contributing Benefactor $30,000	Supporting Benefactor $40,000 Benefactor $25,000
Supporter $12,500	Patron $10,000


A Tribute to Mr. Harold "Hal" and Mrs. Johncyna "Jo" McRae (Ticket / Table Information)
Please reserve:
Table Ticket(s) for 10 at $1,000	Table Ticket(s) for 8 at $800
Individual Ticket(s) for $100

General Donations

I pledge:

To make a tax-deductible contribution of $ to support the FHCCM Foundation's initiatives in the expansion of access to affordable, quality health care for underserved individuals and communities and to promote fundamental improvement in the health status of the people in the Manatee County Rural Health Service Area.

Please fill out all the fields below and click Submit. Please note that all fields are required fields.

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Logistics Contact
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Please enter security code exactly as shown.

The FHCCM Foundation, Inc. is tax-exempt under IRS Code 501(c)(3).

Downloadable Pledge Form

For more information about Family Health Care Centers of Manatee Foundation, please use one of following options:

Telephone: (941) 752-6588

Email: Charlie Wells, Executive Vice-President of Foundation and Intergovernmental Affairs
cwells@fhccm.org

Sylvia Camarena, Special Executive Assistant
scamarena@fhccm.org

Shawny Robey, Marketing and Public Relations Director
srobey@fhccm.org

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