All donations to AG Bell Florida help families, health care providers and education professionals understand childhood hearing loss and the importance of early diagnosis and intervention. AG Bell Florida supports advocacy, education, research and financial aid, to ensure that every child an adult with hearing loss has the opportunity to listen, talk and thrive in mainstream society.

To donate by mail, please send your check or money order to:

AG Bell Florida
Attn: Treasurer
P.O. Box 533035
Orlando, FL 32853

Donor Information

1. First Name*
2. Middle Name
3. Last Name*
4. Company Name
5. Address Line 1*
6. Address Line 2
7. City*
8. State Please Select Alabama Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *
9. Zip/Postage Code*
10. Email*
11. Phone*
12. Indicate one of the following Please Select I have a hearing loss I have a child(ren) with hearing loss I have a grandchild(ren) with hearing loss I am a hearing health professional I am a speech-language pathologist I am a deaf educator I have no connection with hearing loss I’m a parent I’m a professional I’m a deaf and hard of hearing adult Other

Donation

1. Donation Amount $
2. Donation Designation Please Select Scholarships Financial Assistance Chapter Operations
3. This gift is
4. In Honor of In Memory of
5. Name

Mail a letter on my behalf to the following person

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2. Address
3. City
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5. ZIP
6. Phone
7. Email*

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A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-HELP-FLA WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. 100% OF ALL CONTRIBUTIONS ARE RECEIVED BY AG BELL FLORIDA. AG BELL FLORIDA DOES NOT SELL, RENT OR OTHERWISE PROVIDE THE NAMES AND ADDRESSES OF CONSTITUENTS TO ANY OTHER ORGANIZATION OR BUSINESS.