Donor Pledge

To make a tax-deductible donation to the VZV Research Foundation, please complete the following form and submit, via email, to the Foundation. Shortly after receiving your pledge, we will send a reminder card and return envelope to you by postal mail.

Please note that:
  • VZV Focus, the Foundation's semiannual newsletter, can be obtained for an annual donation of $25.00 or more.
  • VZV Focus, the VZVRF annual report and other materials the Foundation distributes (e.g. articles and proceedings of scientific meetings) can be obtained for an annual donation of $100.00 or more.
Donor Pledge Form
Name:
Address:
City:
State or Province:
Zip:
Country:
Home Phone:
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Fax:
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E-mail Address:
Pledge Amount:
Does your employer have a matching gift program?
No
Yes

(please press only once to submit)