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Support the Duke Center for Macular Diseases
Please enter the information requested on this form and then click on SUBMIT at the bottom.
Then print the page that follows and mail it, along with your check, to the address provided.
Please make your check payable to Duke Eye Center/AMD.
Donate by Check
I would like to make an unrestricted gift of
*$:
to the following Macular Degeneration Program(s) (check as many as necessary)
Macular Degeneration Research
Macular Translocation Research Program
Patient Support - patient education, low vision rehabilitation program, and patient/family support program
Other
please specify Other:
If more than one designation is specified, your gift will be divided equally among those you have designated.
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