Donate by Mail Form - American Cancer Society
Please mail this form and your check to:
American Cancer Society
PO Box 6704
Hagerstown, MD 21741
(Please PRINT all information clearly.)
Date:
Enclosed is my check in the amount of $
payable to the American Cancer Society.
My name:
Address:
Phone:
City/State/ZIP:
(Receipt will be sent to the address above.)
Type of Donation (please choose one):
¡õ General Donation
¡õ Gift in memory of:
(name of deceased)
Send acknowledgement card to:
Name:
Address:
City/State/ZIP:
How would you like the card to be signed?
¡õ Gift in honor of:
(name or names)
(name of individual)
Send acknowledgement card to:
Name:
Address:
City/State/ZIP:
How would you like the card to be signed?
(name or names)
We thank you for your support.
Your contribution is tax-deductible. To reduce administrative costs, your gift will be processed at a central facility.
The American Cancer Society cares about and protects your privacy. The information you provide to the Society will only be used as described in our
privacy policy, about-us/policies/privacy-statement.html.
?2022 American Cancer Society, Inc.
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