Donate Online Now

Thank you for making a gift to Hospice of Northwest Ohio. You may do so conveniently by filling out and submitting this form electronically on our secure site. You will immediately receive an email confirmation that your information has been received. In addition, you will receive an acknowledgement of your gift via U.S. mail. You can also download a form here and send it via U.S. mail.

Please note: If your gift is being made in memory or in honor of someone, we will notify the individuals you are honoring or the family members of the person you are remembering. Please be sure to provide complete contact information for these individuals when filling out this form.

If you would like to discuss a major gift or are interested in supporting a certain project, please contact:

John Lechman, CFRE
Director of Development
Phone: 419-931-5187

* = Required

 Yes! I would like to make a donation to Hospice of Northwest Ohio.

I would like to donate:

 I would like to make a recurring donation.

Donor Information

Name of Donor
Phone Number
 I am donating on the behalf of another individual or organization.
 I am donating on the behalf of a group of people.

Is this Gift in Memory or Honor of Someone?


How This Gift Should Be Used

(Please select one category for your gift.)
 2017 Annual Fund
 Light Up a Life Annual Gift
 Gift is unrestricted and should be used where the need is greatest
 Gift is in support of a special event or project

Matching Gift Program?
Many area employers sponsor matching gift programs for employees or retirees. This could double your gift to Hospice of Northwest Ohio.

 My employer has a matching gift program.

Donor Address

(must match billing addess for credit card)
Address 2

Payment Details

Selected Donation
Select Card Type
(as it appears on the credit card)
Card Number
(no dashes or spaces)
Exp. Date
Comments (for HNWO in processing this donation)