Walla Walla Community Hospice

FIELDS MARKED * ARE REQUIRED.

TREE OF LIFE - ORDER FORM

The following information is requested so that we may contact you if we have any questions regarding your gift or order. 

 

Please note that the maximum number of names that may be submitted via this form is FOUR.  If you wish to add more than four names to the Tree of Life, please indicate the TOTAL number and the appropriate donation amount, and the first three names on this form.  Please email additional names to info@wwhospice.org , after you have completed your order and reference this order information.

 

Note: We have limited quantities of previous years glass ornaments if you are interested in purchasing one, please call the office at 509-525-5561.

 

(Click here for more Tree of Life details. You may also call the office.)

 

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Order Details

I would like ___ lights to shine on the Tree of Life (list names below)
Number of lights (above) multiplied by $10 = subtotal amount
I would like ____ commemorative glass tree ornaments.
Number of glass ornaments (above) multiplied by $25 = subtotal
Additional year-end donation $

 

 

Add amounts above to determine total amount for lights, ornaments, and year-end donations. Place that total below.

Donation Amount*
$

Acknowledgement Details

First person to be remembered on Tree of Life

First name
Last Name
If you would like for us to send a Tree of Life card regarding your gift to another party, please enter the name and address of the person below.  An acknowledgement card is an addition to a donation receipt letter which will be sent to you.
Send acknowledgement to
at this address

Second person to be remembered on Tree of Life

First name
Last Name
Send acknowledgment to
at this address

Third person to be remembered on Tree of Life

First name
Last Name
Send acknowledgement to
at this address

Fourth person to be remembered on Tree of Life

First name
Last name
Send acknowledgment to
at this address

 

If you have ordered glass ornament(s), would you prefer they be sent to you, or with the acknowledgement cards?

 

If your total order is for more than three lights, please email additional names to info@wwhospice.org , after you have completed this transaction.

 

Payment Information

Amount*
$
Name on Card*
Card Number*

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