If you wish for this donation to be made in the honor or memory of an individual, please provide their information below:
(If not, leave this form blank and click the Proceed to Paypal button to donate.)
In Honor/Memory of:
Recipient Name:
Recipient Address:
Recipient City:
Recipient State:
Recipient Zip/Postal Code:
Recipient Country:
(Will be included in acknowledgement)
TargetCancer will provide a letter acknowledging this donation to the individual being honored, or to their family.