Make a check to:
THE AUXILIARY, UCSF MEDICAL CENTER AT MOUNT ZION
1600 Divisadero St./Box 1606
San Francisco, CA 94143-1606
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Make a check to: THE AUXILIARY, UCSF MEDICAL CENTER AT MOUNT ZION 1600 Divisadero St./Box 1606 San Francisco, CA 94143-1606 |
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Membership Dues* |
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| £ | Individual | $35.00 | |||
| £ | Family | $50.00 | |||
| £ | Sponsor from: | $100.00 | |||
| £ | Senior | $25.00 | |||
| £ | Special Gift (acknowledge for special programs, honorees, in memory of, etc.): | $ | |||
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TOTAL AMOUNT ENCLOSED: |
$ |
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* All Membership donations over $15.00 are tax deductible to the extent allowed by law
| PLEASE PRINT: | |||
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Membership Year July 1, |
_____ to June 30, _____ |
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Indicate your interest as a volunteer by checking here: |
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