City, State, Zip _______________________________
Home Phone __________________________________
Cell or Work Phone _____________________________
*If you are a lifetime member and would like to make an additional contribution, please indicate the amount of your donation $_______________.
If Employee please indicate:
Saint Francis Campus _________
Mount Sinai Campus __________
I would like to be contacted to learn more about volunteer opportunities.
Please make your check payable to :
The Auxiliary at Saint Francis
114 Woodland Street
Hartford, Connecticut 06105
Thank You for Generous Support of our Mission