Organization Name (required)

501(c)(3) EIN Number (required)

Primary Billing Contact (required)

Billing Address (required)

City (required)

State (required)

Zip Code(required)

Phone Number (required)

Email (required)

Secondary Billing Contact (required)

Secondary Billing Phone (required)

Secondary Billing Email (required)

Select what your organization operates (required)
US clinic or outreachInternational permanent clinicShort-term international medical trips

How did you find out about Blessings International?

501(c)(3) Tax Identification Letter is required to create your account. Please upload your IRS Letter of Determination.

I acknowledge that by submitting the above information, Blessings International may use the information to contact me (and those I’ve listed) regarding my account, offers, services, etc. (Blessings International never sells or shares contact information.)