捐赠 to the Foundation

You can change lives with your gift and make a difference, today! 捐赠 to the Foundation today using the form below, or download the PDF below and donate via mail.

PHCF Donation Form (294.92 KB)

Online 捐赠 Form

Please complete the form below. After you press the submit button, you will be taken to a page that will allow you to process your payment.

^* Required

Title

First Name ^*

Please confirm your First Name

Last Name ^*

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Email Address ^*

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Billing Address ^*

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城市 ^*

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状态 ^*

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Zip Code ^*

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Country

首页。 Phone Number

Work Phone Number

Cell Phone Number

I would like to make a contribution of $ ^*

Please confirm your 捐赠 Amount

I would like this donation to be allocated to (please select one)

The area of greatest need

Special Project

Details of special project

Recognition

Please recognize my gift in the name listed below

I would rather be recognized as Anonymous

This is a Memorial / Tribute gift honoring the person below

Enter recognition information (your name, etc) If you are recognizing someone else, please include name and address of person you want to recognize (if applicable).

Is it ok to notify this person of the gift?

Honoree's mailing address

Payment Method -- Note: 现金 or check donations can be mailed to Plumas Health Care Foundation 1065 Bucks Lake Road Quincy, CA 95971 ^*

现金

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Credit Card

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