Memorial gifts and/or Honorariums may be given to Hospice of Union County by providing the following information, printing the completed form and mailing it, along with your check to:
HOSPICE OF UNION COUNTY, 700 W. ROOSEVELT BLVD., MONROE, NC 28110
All donations are tax deductible.
To give a Memorial Gift:
Donor's Name (memorial gift):
Address:
City:
State:
ZIP:
Phone Number (Day):
Phone Number (Evening):
Cell Number (optional):
E-Mail Address:
Enclosed is my gift of:
Credit Card Type:
Card Number:
Expiration Date:
Today's Date:
Signature :_____________________________
(Please sign after printing window)
To give an Honorarium:
Honorarium in Honor of::
Donor's Name:
Address:
City:
State:
ZIP:
Phone Number (Day):
Phone Number (Evening):
Cell Number (optional):
E-Mail Address:
Send Card To:
Address:
City:
State:
ZIP:
Enclosed is my gift of:
Credit Card Type:
Card Number:
Expiration Date:
Signature :_____________________________
(Please sign after printing window)
Today's Date: