Black and White AMDF Logo - Saving sight through research and education

Please make your check payable to the
American Macular Degeneration Foundation
and send your check to:

American Macular Degeneration Foundation
PO Box 515
Northampton, MA 01061-0515


A Gift Donation from:

Name ____________________________________________________

Address __________________________________________________

City ________________________________State_____Zip_________

Special Occasion Honoree:

Name_______________________________________________________

Address ___________________________________________________

City _________________________________State_____Zip_________

Special Occasion:

_____ Birthday    _____ Get Well
_____ Marriage    _____ Wedding Anniversary    
_____ Mother's Day    _____ Father's Day    
_____ Christmas    _____ Chanukah    _____ Kwanzaa


_____ Yes, I would like to send the AMDF Newsletter, In the Spotlight, as a gift.

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