Thank you for your interest in supporting the tribute page of HOWARD MCCLAFLIN and
The Michael J. Fox Foundation for Parkinson's Research.

Your gift is very much appreciated as a charitable donation and is tax-deductible.
Please print out this form, fill it out, and send it the Foundation at the address listed below.

 

Name:

Billing Address:

City: State/Province: ZIP: Country:

Phone: Email:

Method of Payment: Check (payable to the Michael J. Fox Foundation)

Please Charge My: Visa MasterCard American Express Discover Account

Number: Exp. Date:

Name on Card: Donation Amount:

The page creator will be notified of your gift. Would you like to send a notification to someone else?

Name:

Address:

City: State/Province: ZIP: Country: