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Giving Form

Giving Form

Required fields are marked with a

Full Name
Address
City
State
Zip Code
Phone Number
Email Address
I/We wish to make a gift to Pekin Hospital Foundation in the amount of
Please call me for my credit card information in the
Morning (8-11)
Midday (12-2)
Afternoon (2-6)
Evening (6-9)
Please use my gift for
Where most needed Department specified below
I wish to donate towards the following department
My gift is in memory of
My gift is in honor of
Please send notification of my memorial or honor gift to: (Name, Address, City, State & Zip)*

Characters remaining:
Name of Matching Gift company (if applicable):
Please check if interested in making a planned gift.
I/We may want to make a bequest (name Pekin Hospital Foundation in my/our will).
I/We may want to give stock to the Pekin Hospital Foundation and receive income for life.
I/We want to know about the tax benefits of giving real estate.
Please send information regarding gift giving.

*The amount of your gift will not be mentioned on notification.
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