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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BILLING INFORMATION 
First Name * 
Middle Initial 
Last Name * 
Address * 
Address 2 
City * 
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Email * 
Phone * 
Country * 
MEMBERSHIP LEVELS 
Choose Membership Level * 
If using a mobile device, please select your preferred member level from the drop down menu twice.

Name as you wish to be listed in print * 

 
GIFT DESIGNATION 
A minimum of $1,000 from each membership gift will be designated to the Excellence for Leading Medicine fund which supports Houston Methodist's greatest opportunities as determined by the President & CEO. 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 * 
Additonal Designations * 

If Other, please specify:


Please contact Amanda Harris, Assistant Director for Leadership Giving at 832-667-5813 or abharris@houstonmethodist.org to discuss additional designation options. 
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Payment Information
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