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Diabetes Coalition of Palm Beach County

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Home
About Us
Volunteer
Data
Resources
Why Join?
Events
Sponsors
Donate

Become A Donor

Through your generous donation, the Diabetes Coalition will be able to make a tangible impact in the fight to defeat diabetes in Palm Beach County.

We thank you!

Donor Information
Name:*
Phone:*
Email Address*
Mailing Address:*
Individual Donations
Please Select the Donation Amount:*
- $25.00
- $50.00
- $75.00
- $100.00
- $250.00
- $300.00
- $500.00
- $1000.00
- Other
Enter Donation Amount*
Method of Payment*
- Cash
- Check (Please make all checks payable to Diabetes Coalition of Palm Beach County)
- PayPal (select this option to pay with debit / credit card)
Our Mailing address here: Diabetes Coalition of Palm Beach County C/O
Keiser University 2085 Vista Parkway West Palm Beach, Florida 33411
Please Select the Donation Amount*
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Is this Donation in Special Recognition?*
- No Thank You
- In Honor Of
- In Memory of
This Gift Is In Honor Of
First Name*
Last Name*
This Gift Is From
First Name*
Last Name*
Relationship (relationship to the honored person)*
This Gift Is To
First Name*
Last Name*
Phone Number*
Relationship (relationship to the honored person)*
Message:*
Send Gift Notification By*
- By Email
- By Mail
Email Address*
Mailing Address*
Additional Information*
This Gift Is In Memory Of
First Name*
Last Name*
This Gift Is From
First Name*
Last Name*
Phone Number*
Relationship: (relationship to the memorialized person)*
Message*
This Gift Is To
First Name*
Last Name*
Phone Number*
Relationship: (relationship to the memorialized person)*
Message*
Send Gift Notification By*
- By Email
- By Mail
Email Address*
Mailing Address*
Additional Information*

66325

CONTACT US

info@diabetescoalitionpbc.org

2051 MLK Jr. Blvd. Suite 306
Riviera Beach, FL 33404

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