About Us How You Can Help Events Staff & Board of Trustees faq.html Newsroom

HOME >> MAKE A DONATION

Please use following form to prepare your donation on line. A member of the Foundation staff will contact you to complete your donation.
If you prefer to mail your donation to us, please download this form.

* Indicates a required field.

Type of Donation  
I want to make a single gift of:*
I want to make a monthly gift of:

Totaling:
Minimum total gift $60.00 or $5.00 per month. We will charge your card each month from the date of your initial gift.

to benefit:*
Fund:*
I’d like my gift to benefit
the following program:
  If Other, please indicate:
 
Donor Information  
  Mr. & Mrs. Mr. Mrs. Ms. Dr.
First Name:*
Middle Name:
Last Name:*
Address 1:*
Address 2:
City:*
State:* Zip:*
Country:
E-mail:*
Telephone:*
   
My gift is: Anonymous
  If your donation is to be made in honor or memory of someone, please complete the following:
  In Honor of In Memory of
  Name:
   
Send notification to:  
First Name:*
Last Name:*
Address 1:*
Address 2:
City:*
State:* Zip:*
   
May we contact you?  
Yes, please add me to your mailing list to receive publications, appeals for support and event invitations.
No, thank you. I’d rather not receive mailings at this time.
   
If you have any questions about this form or would prefer to make a
donation via phone please call us at 802.772.2458.
Please enter these numbers to complete this request.
This has been added to stop spam.
 

Rutland Health Foundation:: 439 West Street :: Rutland, VT 05701 :: 802.747.3634 :: LINKS :: HOME
ABOUT US :: HOW YOU CAN HELP :: EVENTS :: OUR STAFF AND BOARD OF TRUSTEES :: FAQ :: NEWSROOM :: CONTACT US :: MAKE A DONATION

© Rutland Health Foundation :: Site by: J.E.G. Design, Inc.