Houston Methodist. Leading Medicine.

The Society for Leading Medicine Membership Form

We invite you to become a member of The Society for Leading Medicine, Houston Methodist's annual giving society.

Comprised of an exceptional group of community leaders with enthusiasm and dedication to Houston Methodist, The Society members are essential to fulfilling our vision for the future. Thank you for your support of Houston Methodist and The Society.

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MEMBERSHIP LEVELS 
Choose Membership Level * 

Select Gift Frequency * 
Select Annual Gift Method 
GIFT DESIGNATION 
A minimum of $1,000 from each membership gift will be designated to an Excellence for Leading Medicine fund which supports Houston Methodist's greatest opportunities as determined by the hospital leadership. Contributions above $1,000 may be partially designated to a Houston Methodist priority area. 

 
I would like to direct the full amount of my gift to the Excellence for Leading Medicine Fund at the following entity * 
Please contact Amanda Harris, director of development at 832-667-5813 or abharris@houstonmethodist.org to discuss additional designation options. 
Donor Information 
This gift is from... * 
First Name * 
Middle Initial 
Last Name * 
Name as you would to like it appear on acknowledgements * 
Address 1 * 
Address 2 
City * 
State * 
Country * 
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Phone * 
Email * 
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