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STEP #2

STEP 2

2

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DONATE ONLINE NOW

RECOGNIZING THE CARING AND DEDICATED REDFIELD CMHC STAFF

Date*

First Name*

Last Name*

Company Name (if a company should be recognized for the donation)

Address - Line 1*

Address - Line 2 (Apt., Unit, etc.)

City*

Zip Code*

State*

Phone Number (include area code)

Email Address*

I prefer to make this donation anonymously. (Your name will only be used to issue a donation receipt.)

CAMPAIGN NAME:

"RECOGNIZING THE CARING AND DEDICATED CMHC STAFF"

Provide First And Last Name Of Redfield CMHC Staff Member That You Are Recognizing:*

2-Provide Information As To Why You Are Making A Donation In Recognition Of A Redfield CMHC Staff Member, i.e. Quality Patient Care, Clinical Excellence, Safety, Advocacy, Community Outreach, Emergency Response, Teamwork:*

**Please consider adding 3% to your donation to cover processing fees**

Adding 3% allows more of your donation to go directly to Redfield CMHC Foundation.

Donation Amount*

$25

$50

$100

$250

$500

$1,000

PERMISSION:

Select One*

I give permission for my name to be used on the Foundation's website in recognition of my donation.

I do not give permission for my name to used on the Foundation's website.

IF YOU DON'T RECEIVE AN EMAIL DONATION RECEIPT WITH THE FOUNDATION LOGO -

PLEASE CHECK YOUR SPAM FOLDER

CONTACT

Jessica Muellenberg

Executive Director

PHONE

(605) 475-7402

EMAIL

jessicamuellenberg@redfieldcmh.org

ADDRESS

PO Box 288
Redfield, SD 57469

FOLLOW

Donor Policy

Redfield CMHC Foundation Inc. is a registered 501(c)(3) nonprofit under

EIN 46-0433111. Donations are tax-deductible to the fullest extent allowable under the law.

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