Caring Hearts International
Donation Form
Please fill out the information below, print and attach your donation.

Mail To:
Caring Hearts International
PO Box 2214
Auburn, WA 98071-2214

First Name: Middle Initial:

Last Name: 

Partner Name:      

Address, Line 1:         

Address, Line 2:         

        City:

State/Province:       

ZIP/Postcode:    

   Country:

Please provide at least one of the following means of contacting you about your donation:

Phone Number:        

 Email Address:        
Please choose a donation level (U.S. Currency):
  • CARING FRIEND Annual gifts up to $100
  • CARING PARTNER Annual gifts up to $500
  • CARING ADVOCATE Annual gifts up to $1,000
  • CARING SUPPORTER Annual gifts up to $2,500
  • CARING GUARDIAN Annual gifts up to $5000
  • CARING PROVIDER Annual gifts up to $10,000
  • CARING PATRON Annual gifts up to $25,000
  • CARING BENEFACTOR Annual gifts of $50,000 or more
Please indicate the amount of your annual donation:

$

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Or make an annual pledge of: $ in paid installments of: $

Click one: Biannually   Quarterly   Monthly

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Please complete the following if you would like to make this a tribute donation:

This donation is:   in Honor of  in Memory of

Name(s):

Please send an acknowledgment card to the following:

First Name: Middle Initial:

Last Name:

Partner Name:

Address, Line 1:

Address, Line 2:

City:

State/Province:

ZIP/Postcode:

Country:

Please print the form now.
Please make checks payable to Caring Hearts International.
Your donation helps to alleviate the health care crisis in Nigeria.
Caring Hearts International  is a 501(c)(3) designated organization, all donations are tax deductible.

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