National MS Society Memorial Funds

Fundraising Page Information

Campaign Title*

Page Link*

Custom page link requirements: only letters, numbers, dashes, or underscores.Your page link: https://donate.nationalmssociety.org/campaign/

Campaign Date*

Show a date for your campaign on your fundraising page.

Make a Self-Donation*

Yes! I want to kickstart my fundraising by making a self- donation to create a world free of MS. No, thanks.

Registration Questions

Please enter a short description to distinguish this fund from others for the National MS Society Staff.

Honoree's First Name*

Honoree's Middle Name

Honoree's Last Name*

Honoree's Suffix

Honoree's City

Honoree's State

Honoree's Zip/Postal Code

Honoree's Email Address

(ex: example@example.com)

Date of Death

(ex: mm/dd/yyyy)

Name of Funeral Home (if applicable)

Next of Kin First Name*

Next of Kin Last Name*

Next of Kin Suffix

Next of Kin Address 1*

Next of Kin Address 2

Next of Kin City*

Next of Kin State*

Next of Kin Zip/Postal Code*

(ex: 12345, 12345-1234)

Next of Kin Country*

Next of Kin Email Address

(ex: example@example.com)

Next of Kin Phone Number

(ex: 123-123-1234)