SECURE ONLINE GIFT FORM (SSL Secure)
This Online Form is SSL Secure
Thank you for making a gift to help create Exceptional Care for patients at Annie Penn Hospital.
To designate your gift, select from the list in the Gift Purpose section. To support a program or fund that is not listed, click Other Designation, then in the Other field type in to where you want your gift designated.
For assistance with this form or information about other giving opportunities, please call 336.951.4663 during business hours (8:30 am –5 pm Eastern) or email firstname.lastname@example.org.
For gifts of $1,000 or more you are recognized as a member of the
Rockingham Society. Thank you.
If your gift is part of the Heritage Club, please indicate in the Additional Comments section below.
Enter address, city, state, and postal code
as filled with your financial institution.