Foundation Contribution Form

Online Contribution Form

"Many people have been capable of doing a wise thing, more a cunning thing, but very few a generous thing" ? Alexander Pope

You are special! Thank you for considering a gift to Howard Regional Health System Foundation. Your gift will be used to provide patient assistance, staff training, and medical equipment to improve the quality and accessibility for the patients of Howard Regional Health System. You may designate your gift to a specific purpose by selecting from the drop down list below. Gifts designated as "Where Needed Most" will be used to help fund the annual Board of Directors appropriation for equipment. If you desire, you may choose to make your gift in honor of or in memory of a loved one. Memorial gifts of $200 or more will purchase a leaf on our Tree of Life. A memorial gift of $1,000 or more will purchase a bronze stone for the Tree of Life.  Memorials of $1200 or more will purchase a bronze butterfly.  We will contact you to get the exact wording for your stone or butterfly. Leaves bear the name as listed below. Please fill out the requested information below and click "Submit". Thank you again for supporting patient assistance, staff training, and equipment purchases at Howard Regional Health System.

* Indicates a required field.  Please note: Upon clicking Submit, you will be taken to a page to enter additional information and then to a page to process your credit card information.  If you have any questions, please call the Foundation office at 765-453-8458.

Donation Information
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