Memorial Gifts - Washington State Hospice & Palliative Care Organization

You will receive via email a confirmation and receipt of your contribution. If you do not see your receipt, please check your spam or junk mail folder. You may also email mccauley@wshpco.org or call 503.890.7027 for donation/payment troubleshooting.

Donor Name*

Donor Email Address*

Name of Person(s) Donation is in Honor/Memory of

Name of Person(s) Acknowledgment Note will be sent to

First Last

Mailing Address for Above

Email Address for Above

If you'd rather have an e-card sent than a mailed letter, please provide the recipient's email address.

Special Message for Acknowledgment Card (optional)

Contribution Amount

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Billing Information

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

Card Details

Cardholder Name

Total

$0.00