NOHR Foundation
Funding Biomedical Research into the
Preventions, Treatments, Causes and Cures
of Hearing Loss & Deafness

DONATE

Please enter your donation amount        $*
* Indicates a required field
YOUR CONTACT INFORMATION

First Name*:
M.I.:
Last Name*:
Address*:
Address Line 2:
City*:
State*:
Postal Code*:
Country:
Phone*:
E-Mail Address*:

CREDIT CARD BILLING INFORMATION

Card Number*:
Security Code*:
Card Type*:
Expiration Date (MM/YY)*:

CREDIT CARDHOLDER INFORMATION
click here if same as contact information above

First Name*:
M.I.:
Last Name*:
Address*:
Address Line 2:
City*:
State*:
Postal Code*:
Country:

MEMORIAL/HONORARY DONATION (optional)

Name of Person donation is in memory/honor of:
In memory In honor
Name of person to notified about the donation:
Address of person to be notified:
If you wish to pay by personal check, please send a check, payable to NOHR, along with a copy of part 1 of this form, filled in and printed out, to:

National Organization for Hearing Research Foundation
225 Haverford Avenue, Suite #1
Narberth, PA 19072
Voice/TTD: (610) 664-3135
Fax: (610) 668-1428

Donations are used only to support research, not for administrative costs. All donors will receive a written acknowlegement.

A copy of the official registration and financial information may be obtained from the Pennsylvania Department of State by calling toll free, within PA, 1(800) 732-0999. Registration does not imply endorsement.


Sophie SoundCheck
www.sophiesoundcheck.org
 

Home
Mission Statement
History
Special Programs
Preventing Hearing Loss
Research & Grants
Contact

The National Organization For
Hearing Research Foundation

225 Haverford Avenue
Narberth, PA 19072
Phone: 610.664.3135
Fax: 610.668.1428
info@nohrfoundation.org


Make a Donation
Apply for a Grant
Facebook
Twitter
Copyright © 2010 NOHR Foundation. All Rights Reserved.
Hair Cell Photo courtesy of James C. Saunders, Ph.D

Any information provided within this Web site is of a general nature and is not specific to any individual. It should not be considered medical advice. Individuals are encouraged to consult an otolaryngologist or other physician for advice related to hearing and hearing disorders.