Donation Pledge Form-NEP Multimedia Series

To make a donation, please print this page, complete the information, and mail it to us at the address provided below.

Thank you for your support!

Name____________________________________

Address__________________________________

City___________________State_____ Zip ______

I/We therefore pledge $_________ in support of this research and the educational multimedia series by New Era Productions.

Signed___________________________________

Date______________

AND/OR

Enclosed is my check for $_________________

Payable to the UMB Foundation - Center for Celiac Research.

I understand my pledge or contribution will be used to support this study at the center for Celiac Research at the University of Maryland School of Medicine as well as the educational multimedia series by New Era Productions and that my contribution is tax deductible. These funds are being managed by the UMB Foundation.

Please mail to:

The Center for Celiac Research
Pam King
Director of Operations
University of Maryland
20 Penn Street, Room S303B
Baltimore, MD 21201