MULTIPART - Support the Foundation June 2024 "*" indicates required fields I want to donate!* I want to fund scholarships for future physicians I want to fund research No Designation (the Foundation may use my funds appropriately and as needed I want to Pay It Forward Pay it Forward in Honor of:SelectStill Point / Dr. Chris StephensonFor any other designation, or to donate to a specific fund, please call the office, 818-796-6750. 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It’s our pleasure to send a card notifying the person of your gift. In Memorial ofSend a Card toAnonymous Donation I would like this gift to remain anonymous Osteopathic Cranial Academy Foundation MembershipIf you give a total of $100, you become an OCAFoundation Member. If you give a cumulative total of $5,000 in addition to $500 annually, you become an OCAFoundation Voting Member.Donation ReviewAmount Thank You!Please share your Osteopathic story and/or why you chose to support our foundation’s mission:Consent* I agree to terms & conditions provided by the Foundation and by providing my phone number and email, I agree to receive email marketing and text messages from Foundation.Thank you!Please submit the form to process your donation.PhoneThis field is for validation purposes and should be left unchanged. MULTIPART - Scholarship June 2024 "*" indicates required fields I want to donate!* I want to Pay It Forward I want to fund scholarships for future physicians Pay it Forward in Honor of:Still Point / Dr. Chris StephensonStill Point / Dr. Chris StephensonFor any other designation, or to donate to a specific fund, please call the office, 818-796-6750. Amount* Show my support by making this a recurring donation* Yes No Duration:* Monthly Quarterly Yearly Name* First Last Suffix Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Special DonationsDedicated Donation In Honor of: In Memorial of: In Honor ofYou can honor a special person or family member by donating in their name. It’s our pleasure to send a card notifying the person of your gift. In Memorial ofSend a Card toAnonymous Donation I would like this gift to remain anonymous Osteopathic Cranial Academy Foundation Membership I am interested in learning about becoming an Osteopathic Cranial Academy Foundation Member. Please contact me. Yes, I would like to receive e-mails from Osteopathic Cranial Academy about cultivating a new generation of gifted physicians. Donation ReviewAmount Donation Total* Please confirm the Total donation amount is correct. Consent* I agree to terms & conditions provided by the Foundation and by providing my phone number and email, I agree to receive email marketing and text messages from Foundation.Thank You!Please share your Osteopathic story and/or why you chose to support our foundation’s mission:Thank you!Please submit the form to process your donation.PhoneThis field is for validation purposes and should be left unchanged.
