DEPARTMENT OF PLASTIC SURGERY
International Outreach
"Operation Good Samaritan"
To extend a Helping Hand, please print this response form and mail to:
Operation Good Samaritan
Department of Plastic Surgery
Loma Linda University
11175 Campus Street, CP 21126
Loma Linda, CA 92354
Name: ___________________________________________________________________
Address: _________________________________________________________________
City/State/Zip: ____________________________________________________________
I wish to make a donation to Operation Good Samaritan of $_______________________:*
_____ My check is enclosed
_____ VISA
_____ MasterCard
_____ Discover
_____ American Express
Credit card number: _______________________________________________________
Credit card expiration date: _________________________________________________
Signature (credit card gifts): __________________________________________________
Please call me at (______) _____________________ to discuss gift, tax, or estate options.
*Contributions are tax-deductible.