M4SPH Donation Form
Fill in your information as donor, choose your payment option, and then hit the "Submit" button. If you are mailing in your payment, we will associate your completed form with the donation when it arrives. If paying by PayPal, "Submit" the form and a response will appear with the PayPal link to process your donation. Thank you for your gift of support!
Sign in to Google to save your progress. Learn more
Email *
First name *
Last name *
Mailing address *
Telephone number (optional)
Amount of one-time donation (minimum $5). If donating monthly, see next. *
Amount of monthly donation (minimum $5).
How would you like tp process your donation?
Clear selection
Donation details
1) If donating through PayPal, you will receive a PayPal link to process your donation after you submit this form.

2) If you are mailing a check, the address to send to is M4SPH, c/o Paul Warrick Treasurer, PO Box 5113, Kincheloe MI 49788-5113

3) If you have "Bill Payment" service through your bank/credit union, you can set up a payee account for "Michigan for Single Payer Healthcare" or "M4SPH" using the address given in line 2 above.
Comments/questions
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy