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Online Contribution - Chester River Health Foundation

Please accept this heartfelt gift to Chester River Health Foundation

Payment Method: (Please check one)
Visa
Mastercard
American Express
Discover

Gifts of securities, real estate, and existing life insurance policies are also welcome.

Please call (410) 778-7668 ext. 4013 for transfer instructions.



Gift Amount

$5,000 $1,000 $500
$250 $100 other amount of $

Card Number:  No spaces or dashes please
Expiration Date:  (MMYYYY)

Name:
Street:
City: State:
Zip:

Phone: E-mail:


You may use my/ our name for recognition purposes.
No
Yes

Birthdate(s) (Optional)  Mine
 Spouse (if applicable) 

Don't forget - you can double your gift if your company has a matching gifts program!

Your gift is tax deductible. Federal ID 52-1338861


My/our gift is:
I/ we would like to designate
my/ our gift for:
In memory of:
In honor of:

Please send an acknowledgement to:
Where Needed Most
Hospital Services
Long-term Care
Hospice Services
Other (please specify):

I/We have made a gift to Chester River Health Foundation in my/our will.
I/We would consider making a gift to Chester River Health Foundation in my/our will.
Please send me additional information about:
Estate & Financial Planning Annual Golf Tournament Volunteer Opportunities
Sporting Clays Tournament Black Tie Gala
We welcome your comments and suggestions:
Your contribution is 
   secured through:
 

If you have any questions, please contact
Chester River Health Foundation
100 Brown Street.
Chestertown, MD 21620

(410) 778 - 7668 extension 4013
   
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100 Brown Street · Chestertown, MD 21620
410.778.3300 or 410.758.2450

Questions or suggestions? Call Corporate Communications 410.778.7654 or email gethealthy@chesterriverhealth.org

� 2010 Chester River Health System is a member of the University of Maryland Medical System (UMMS). All rights reserved.