HeartGift - How to Donate

To send a tax-deductible contribution to HeartGift, please print this page, and send the completed form with your check (payable to HeartGift) to:

Amount of Gift:

Donor Name (Please Print)

Business Name (if applicable)

Contact Person

Mailing Address

City

State

Zip

Area Code

Phone Number

This Gift Given (optional information)

In Memory of:

In Honor of:

Please send notification of this gift (amount will not be disclosed) to:

Name

Address

City

State

Zip

This Gift is to be used for:

Area of greatest need

Restricted to: