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 The Healing Gardens

at Cone Health Cancer Center and Wesley Long Hospital

Online Credit Card Gift Form

 

Thank you for choosing to make a charitable gift to help create The Healing Gardens. You will receive electronic confirmation of your gift immediately and written confirmation thereafter.

 

For honor or memorial gifts of $1,200 you can have a permanent plaque mounted along the wall overlooking the Gardens.

 

To discuss naming opportunities for larger gifts, other ways to make your gift or pledge or for questions about this form or the plaques, call 336.832.9450 during business hours (9 – 5 pm Eastern) or email fund.development@conehealth.com.

 

Thank you for your support.

 

 

 

Gift Information

Donation Amount*
  • $25
  • $50
  • $100
  • $250
  • $1,200
  • Other $

Your Contact Information

Preferred Title
First Name*
Middle Initial
Last Name*

 

Spouse/Partner:

Title
First Name
Middle Initial
Last Name

Enter address, city, state and postal code
as filed with your financial institution.

Country*
Address*
City*
Postal Code*
Email*
Confirm Email*
Daytime Phone*

Honors and Memorials

I/We would like this gift to be in:

 
  • Memory Of
  • Honor Of
Honoree's Name
For the following occasion:

 

Please Notify:

Name
Address
City
State
Postal Code
Country

Recognition

Please list my/our name(s) in donor recognition materials as:

 
  • This gift is anonymous, do not publish
  • I/We are interested in helping raise more money for the Healing Gardens. Please contact me/us.

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code

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