Yes! I would like to be a Friend of the Auxiliary.

Please print this page, fill out the form, and mail it to the Friends of the Auxiliary.

Printer friendly version of the form.

Friends of the Auxiliary
Attn: Development Office
Community Hospital of the Monterey Peninsula
Post Office Box HH
Monterey CA 93942-9910

Please write your name exactly as you wish it to appear on the
Friends of the Auxiliary roster.

Name: ___________________________________________________________
                                         (Please print)

Address: _________________________________________________________

Phone number: __________________  

E-mail address (optional):________________________

My Friends of the Auxiliary gift:

$25  $50  $100  $250  Other   $_________________

My gift is   in honor of:    in memory of: 

______________________________________

Please provide notification (with gift amount undisclosed) to:

_______________________________________

Address: _______________________________ 


City/State/Zip:__________________________

Your gift is tax-deductible according to IRS regulations. Tax ID #94-2789696