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Sam Ayers: Lombardi Cancer Center Donations

To make a gift to the Lombardi Cancer Center at Georgetown University, print this page, complete the form and mail it with your check as indicated. To donate by credit card, use the online form.

Yes! I want to support Lombardi's patient care, research and education programs. Enclosed is my gift. Please designate this gift for Cancer Research.

Gift Amount: $

This gift is given in memory of: SAM BIELICH

Please notify:
SAM AYERS
10061 RIVERSIDE DR. #247
TOLUCA LAKE, CA 91602
My Name:

Address 1:

Address 2:

City:

State/Province:

Zip/Postal Code:

Country:

Daytime Phone:

Evening Phone:

E-mail Address:
Please mail your gift payable to:
Lombardi Cancer Center
New Research Building, Room E501
3970 Reservoir Road NW
Washington, DC 20007
USA
Phone: 202-687-2956
Fax: 202-687-6402
Note: Donation is tax deductible in the U.S.; check your local tax regulations elsewhere. Donations in U.S. Dollars only.


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