Women's Dermatologic Society

$2500 $1000 $500 $250 $125 Other Amount (minimum $10)

* Amount to Charge:

$ .00

If you would like to make this a Recurring Donation* please fill out one of the options below
*(A pledge of a specific amount over the time period of your choice.)

No Thanks, I'd rather do a One-time Donation.

Complete this section for Recurring Monthly Donation:

Complete this section for Recurring Annual Donation:

Consent and Authorization

I consent and authorize my bank/credit card to make recurring payments until I notify the Women’s Dermatologic Society (WDS) otherwise. First charge to occur upon the submission of this form. I understand that I may cancel or change my recurring donation at any time by notifying WDS at (414) 918-9887. A record of each payment will appear on my monthly bank or credit card statement and will serve as my monthly receipt. A letter showing cumulative donations for the calendar year will be sent each February.

Please complete this section for Honor and Memorial donations:

The special person or occasion:

You can choose to send your card to two (2) people

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Card Recipient Name #2

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WDS Legacy Donation Form

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