Medical Library Association | Librarians Without Borders : Medical Library Disaster Relief Fund

MLA Medical Library Disaster Relief Fund

The MLA Medical Library Disaster Relief Fund accepts monetary donations to assist medical libraries impacted by natural and man-made disasters throughout the world. To contribute to this fund, please use the form below.

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Donation Form

Fill in the following information including your credit card data or request for invoice for your donation. Please make sure to fill in fields marked with a red asterisk ( * ) to ensure we can appropriately acknowledge your contribution or invoice your pledge.

MLA will be acknowledging donations on MLANET and in other forums. Please let us know how you would like us to acknowledge your donation.	You may use my name in a list of donors to the fund Please let my donation be anonymous
First Name *
Last Name *
Billing address
Billing address 2
City
State or Province
Zip code/Postal code *
Country (if outside the US)
Phone *
Email address *

Donation Amount
$500 $100	$ 50 Other amount:

Payment Type

Credit card

Name on card: *

Card number: *

Card exp. date (mm/yy): *
Card Security Code: *

Pledge / Invoice me
(for MLA members only)

Invoice reference message:

By Fax or Mail
Print and fax or mail a copy of this form with your check (made out to "Medical Library Disaster Relief Fund") or credit card information to MLA's payment processing center:

Medical Library Association
36348 Treasury Center
Chicago, IL 60694-6300

For more information or if you have questions, contact Carla Funk, funk@mlahq.org, 312.419.9094 x14.

MLA Medical Library Disaster Relief Fund

Thank you for your generous contribution.