Sarena Seifer Leadership Fund Donation Form
The fund was created to honor and sustain the legacy of our founding executive director's leadership and commitment to partnerships for social change. The fund's purpose is to ensure a consistent and strong CCPH voice and influence in the policy arena.
 
Donation Options
Please indicate your donation amount:
Other: $
Would you like us to include your name among the donors listed on the leadership fund website?
Yes
No
If you would like to include a note to Sarena to accompany your donation, please add it here:
 
Profile Information
Member ID
First Name
Last Name
Title
Organization
Address
Address 2
City
State/Province
Zip Code/ Postal Code
Phone
Email