Serve & Donate:
    Chester River
    Health Foundation

    An Introduction
    At Chester River
    Hospital Center
    At Chester River
    Home Care &
    At Chester River

Online Contribution - Chester River Health Foundation

Please accept this heartfelt gift to Chester River Health Foundation

Payment Method: (Please check one)
American Express

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)

City: State:

Phone: E-mail:

You may use my/ our name for recognition purposes.

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
  Joint Commission   ·   HIPAA Privacy Notice   ·   Disclaimer  

100 Brown Street · Chestertown, MD 21620
410.778.3300 or 410.758.2450

Questions or suggestions? Call Corporate Communications 410.778.7654 or email

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