Please donate to support our effort to bring comprehensive healthcare to all Hoosiers. Your contribution will help us print materials, mail information, and much more.

Contributions to HCHP are tax deductible under section 501(c)(3) of the IRS code.

We can only accept personal checks at this time. Please make your check payable to “Hoosiers for a Commonsense Health Plan”. Print this form and mail it, with your check, to:

Hoosiers for a Commonsense Health Plan
P.O. Box 2632
Bloomington, IN 47402-2632

Thank you!!

I enclose my contribution to support the work of HCHP.

Name: ______________________________________________

Address: ____________________________________________

City: ____________________________ Zip: _______________

Email: ________________________ Phone: _______________

___ $10 ___ $25 ___ $50 ___ $100 ___ $500 ___ $1,000

___ Other [specify amount: $_______ ]

This gift is in honor of: _________________________________

Your Gift to HCHP is tax deductible


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