1165 Lincoln Avenue, Suite 300 [map] • San Jose, CA 95125 • (408) 287-3785 • Email Us

Contribution

With an ever-growing number of people diagnosed with diabetes in our region, we need to be there for them to provide assistance. The compassionate education and camping services provided by the Diabetes Society are only possible because of gifts we receive from community supporters like you. Last year we served over 10,000 community members, and educated and entertained 500 children and family members living with diabetes at our camps.

Please take this opportunity to make a difference in the lives of families affected by diabetes in our community. Your tax-deductible gift, no matter how large or small, is appreciated and urgently needed. Please respond today by sending us your donation. Remember, the Diabetes Society is an independent local grassroots organization whose donations stay in our California communities to assist individuals, children and families suffering and living with diabetes.

Donate Online

Please use the form below to make a contribution that is fast and secure. Then click on the "Continue" button, after which you will go to PayPal's secure web site to enter your credit card information. (A PayPal account is not required and major credit cards are accepted).

If you encounter any problems with this page — or have any questions or comments — please send an e-mail to webmasterdiabetessociety.org. Thank you.

Contribution Amount *	$ 50.00 Help pay for the cost of test strips to be used with the meters our clients receive free of charge. $ 100.00 Help subsidize a patient who is uninsured and cannot afford our self-management education programs $ 500.00 Pays for the actual cost for a family to attend one of the Society’s weekend camps $ 1400.00 Pays for the actual Diabetes Society costs of sending one child to a week-long summer resident camp Other Amount
Other Amount	$
	I want to make a one-time contribution. I want to contribute this amount every for installments Your recurring contribution will be processed automatically for the number of installments you specify. You can leave the number of installments blank if you want to make an open-ended commitment. In either case, you can choose to cancel at any time. You will receive an email receipt for each recurring contribution. The receipts will include a link you can use if you decide to modify or cancel your future contributions.
Email Address *	I am contributing on behalf of an organization.

Organization Details

Organization Name

Primary Phone
Primary Email
Street Address	Street number, street name, apartment/unit/suite - OR P.O. box
Addt'l Address 1	Supplemental address info, e.g. c/o, department name, building name, etc.
Addt'l Address 2
City
Zip / Postal Code	- Enter optional 'add-on' code after the dash ('plus 4' code for U.S. addresses).
Country - State	- Type in the first few letters of the country and then select from the drop-down. After selecting a country, the State / Province field provides a choice of states or provinces in that country.

Memoriam and Honorarium Honor and remember your loved ones with a gift to the Diabetes Society. Please fill out the honoree fields listed below so that we may correctly apply your donation to the to the honoree.

	In Honor of In Memory of
Honoree Prefix
Honoree First Name
Honoree Last Name
Honoree Email Address

Contact Information

Salutation
First Name
Last Name
Street Address
City
State
Postal Code
Home Phone

Donate by Mail or Telephone

To donate by mail, download the Contribution Form and mail it with your check or credit card information to:

Diabetes Society
1165 Lincoln Avenue, Suite 300
San Jose, CA 95125

To make a donation over the phone or if you have any question, please call us at (408) 287-3785.

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