New England College of Optometry · Community Health Center 50th Anniversary Celebration Donation Form

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Community Health Center 50th Anniversary Celebration Donation Form

NECO celebrates our partnerships with community health centers in delivering Eye Care for All. For 50 years, our faculty and student interns have proudly provided comprehensive eye care for communities throughout Massachusetts. Our optometrists practice in a collaborative health care model to optimize a patient’s well-being, as they train tomorrow’s optometrists to care for their communities and advocate for healthcare equity. NECO values our health center partners and thank you for your support.

Name

First Name

Last Name

Organization/Employer

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Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Amount

$25

$50

$100

$250

$500

$1,000

Donation Schedule

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Name of Tribute

Add 3% to my total amount to help cover the payment processing fees