捐赠 to the 基金会

You can change lives with your gift and make a difference, today! 捐赠 to the 基金会 today using the form below, or download the PDF below and donate via mail.

PHCF Donation Form (294.92 KB)

Online 捐赠 Form

Please complete the form below. After you press the submit button, you will be taken to a page that will allow you to process your payment.

^* 要求

Title

第一个名字 ^*

Please confirm your 第一个名字

姓 ^*

Please confirm your 姓

电子邮件 Address ^*

Please confirm your 电子邮件 Address

计费 Address ^*

Please confirm your 计费 Address

城市 ^*

Please confirm your 城市

状态 ^*

Please confirm your 状态

邮政编码 ^*

Please confirm your 邮政编码

国家

首页 Phone Number

Work Phone Number

Cell Phone Number

I would like to make a contribution of $ ^*

Please confirm your 捐赠 Amount

I would like this donation to be allocated to (please select one)

The area of greatest need

Special Project

Details of special project

Recognition

Please recognize my gift in the name listed below

I would rather be recognized as Anonymous

This is a Memorial / Tribute gift honoring the person below

Enter recognition information (your name, etc) If you are recognizing someone else, please include name and address of person you want to recognize (if applicable).

Is it ok to notify this person of the gift?

Honoree's mailing address

Payment Method -- Note: 现金 or check donations can be mailed to Plumas Health Care 基金会 1065 Bucks Lake Road Quincy, CA 95971 ^*

现金

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Credit Card

Please confirm your Payment Method

捐赠 to the 基金会

Online 捐赠 Form

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