Mission
Statement

Pediatric
Corneal
Transplantation

Genetic
Research

MAIL-IN DONATION FORM

For individuals who wish to make direct contributions without receiving additional information, the following page can be printed out and filled in:

• Enclosed please find my donation to the EYE BIRTH DEFECTS RESEARCH FOUNDATION, INC. in the amount of $__________.
• This donation is made in the honor of ________________________.
• To celebrate or commenorate______________________________.

Donor Information

Name:______________________________________________
Address:____________________________________________
City, State, Zip:_______________________________________
Telephone No.:_______________________________________

All donations should be mailed to:

EYE BIRTH DEFECTS RESEARCH FOUNDATION INC.
444 South San Vicente Blvd., #1102
Cedars-Sinai Medical Center, Mark Goodson Building
Los Angeles, CA 90048

Thank you so much for helping us in our efforts to prevent blindness.