FIGS - Contribution Form

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Your contribution to FIGS will help low-income Wake County residents get the prescription medicines and medical supplies they need.

For example:

A donation of $15 will buy amoxicillin for a child with an ear infection.

A donation of $75 will purchase a bottle of insulin for a person with diabetes.

A gift of $70 will help someone with high blood pressure get medication for a month.

A contribution of $90 will buy a life-saving inhaler for someone suffering from chronic asthma.

A gift of $125 will supply medication for a person with epilepsy.

Please give whatever you can afford. Your gift will make a difference.

If you would like to make your gift in honor or in memory of someone, please fill out the information requested below:

Your name_________________________________
Your address_______________________________
__________________________________________
Phone number______________________________

I wish to make my gift _____ in honor of OR ____ in memory of:

___________________________________________________________

This gift should be acknowledged to:
Name: _______________________
Address:______________________
_____________________________

**A private donation has been made to FIGS which established a mental health fund. Would you prefer that your donation be earmarked for this special need? ______

Please make checks payable to FIGS and mail to:

FIGS of Wake County
P.O. Box 12821
Raleigh, NC 27605

Financial information about this organization and a copy of its license are available from the Charitable Solicitation Licensing Section at 1-888-830-4989. The license is not an endorsement by the State.