Caring Hearts Campaign Gift Form

Say "thank-you" to the Caring Hearts at Altoona Regional and support community health care!

Please complete the information below, print the form, enclose it in an envelope with your donation and mail to:

ATTN: Foundation for Life
Altoona Regional Health System
620 Howard Ave.
Altoona, PA 16601-9984

For more information, please call the Foundation for Life Office at (814) 889-6406.

For a suggested minimum $25 donation, you may honor health care providers through the Caring Hearts Campaign.     $25     $50     $100     $500     $1,000     Other $

Please make checks payable to: ARHS Foundation for Life

In any publicity, please list me as an anonymous donor.

Name:

Organization's Name (if applicable):

Address:

City, State and Zip:

Phone Number:

Please choose one of the following:

This gift is in honor of:

This gift is in memory of:

Department:

Thank you for your contribution! Your gift is tax deductible to the fullest extent provided by law. If you have any questions, call (814) 889-6406.