Mail a Check Form — HelpCureHD

Please fill out the following form if you are paying via check.

Please make checks payable to Athletes and Causes Foundation - Memo: HelpCureHD

Athletes and Causes Foundation

4525 South Lois Avenue Tampa, FL 33611

To Pay Via Wire Transfer contact arian@helpcurehd.org

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

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Date check was mailed:

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DD

YYYY

Amount

$