TRI Donation Form

 

Please print/complete this form and return with your donation: 

Touch Research Institute

Dept. of Pediatrics (D820)

University of Miami School of Medicine

P.O. Box 016820

Miami, FL 33101

 

Please indicate "Gift to the Touch Research Institute" in the memo field of your check.

 

Name

 

Institution

 

Street

 

City

 

State

 

Zip Code

 

Country

 

Phone

 

Fax

 

 

Check (or money order) Total ___________

 

Thank you for your interest and support of the Touch Research Institute.