Member Physician Wellness Program Donate in Kind Form

Physician Wellness Program

Your in-kind donations will create excitement and provide valuable exposure for your business while supporting our wellness initiative. We welcome any and all types of donations that align with our wellness focus. Thank you for your support!
Donor Name*
Contact Person Full Name*

First NameLast Name
Donor to remain anonymous

YesNo
Contact Email Address*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Donor Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of In-Kind Donation*

TicketsGift CardsExperiencesOther (please specify)
Please describe the in-kind donation you wish to offer*
Special Instructions or Conditions
this may include use by date, black out dates, etc
Estimated Value of Donation (if applicable)
Expiration Date (if applicable)

MonthDayYear
Date
Additional Comments or Questions
Monetary donation

Please scan the below paypal/QR code to donate monetarily to Mass AFP Foundation.
Thank you!

A donation receipt will be sent following the event and we will be in contact with additional needs. Please reach out to MassAFPFoundation@mms.org with any questions or concerns.
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Physician Wellness Program