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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
Vice President, Philanthropy
Phone: 419-931-5187
Email: jlechman@hospicenwo.org
* = Required
Yes! I would like to make a donation to Hospice of Northwest Ohio. |
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Please enter the amount excluding any dollar signs ($) or commas (,). |
Other |
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I would like to make a recurring donation. |
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Your credit card will automatically be billed on the 15th of every month for twelve months for the amount you select. |
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Donor Information |
Name of Donor | |
Phone Number (xxx-xxx-xxxx) | |
Email | |
This gift is from another individual or organization. |
Their Name |
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We appreciate your donations! To show our gratitude, we send all of our donors acknowledgement letters If you would like the person above to receive an acknowledgement letter, please provide their address below. |
Address |
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This gift is from a group of people. |
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We appreciate your donations! To show our gratitude, we send all of our donors acknowledgement letters. If they would like to receive an acknowledgement letter, please list the names and addresses of all those associated with the donation. |
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Is this Gift in Memory or Honor of Someone? |
Yes |
No |
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Please select one category for your gift. |
Gift is a memorial or general donation and should be used where the need is greatest |
Gift is in support of a special event or project |
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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. |
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Donor Address
(must match billing addess for credit card) |
Address | |
Address 2 | |
City | |
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State
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Zip | |
Country | |
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Payment Details |
Selected Donation | $ |
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Select Card Type
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Name (as it appears on the credit card) | |
Card Number (no dashes or spaces) | |
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Exp. Date
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CVV | |
Comments (For HNWO in processing this donation. Not for the family) |
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