Foundation In Kind Donation Form

Donation Form

Your donation supports our mission to increase health equity and access in Wisconsin. The Wisconsin Medical Society Foundation is a not-for-profit 501(c)3 with federal tax ID number 39-6045649.
Company Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Value of Donation
Description of Donation
Delivery Arrangements:
Please mail donations to:

Wisconsin Medical Society Foundation

Attn: Elizabeth Ringle

PO Box 1109

Madison, WI 53701-1109
Should be Empty: