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Donation Form
Donation Information
Amount:
$5,000.00
$1,000.00
$500.00
$250.00
$100.00
$50.00
Other
$
*
Designation:
Mount Hood Programs and Services
Mount Hood Family Birth Center
Mount Hood Emergency Services
Mount Hood Cardiac Services
Mount Hood Cancer Services
Mount Hood Spiritual Care
Mount Hood Patient Assistance
Mount Hood Breast Health Center.
Mount Hood Healing Garden
Mount Hood Helping Hand Fund
Additional Information
Type of gift:
One-time gift
Recurring gift
Frequency:
Weekly
Monthly
Quarterly
Annually
Every 4 weeks
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Anonymous:
I prefer to make this donation anonymously
Comments:
How Did You Hear About Our Site:
Online
This gift is in honor/memory of (Optional)
Type:
In honor of
In memory of
*
Name:
*
First name:
Last name:
*
Mail a letter on my behalf
*
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