Record of Donated Goods

Record of Donated Goods
Thank you for your donation. We are very grateful for your donation for the benefit of children.

Nemours Children’s Health has a reputation for its world-class medical care, but also for its warm, family-centered environment. We value support from the community that enables our staff to enhance the patient experience.
THIS IS YOUR RECEIPT and will be emailed to the address provided.
First Name*
Last Name*
Date

MonthDayYear
Date
Organization Name
Address
City
State
Zip
Email*
example@example.com
Phone*
Description of Items*
Is this donation for an event?*

YesNo
Event Name
Date of Event

MonthDayYear
Date of Event
Are the items you are donating specifically for the Child Life Department?

YesNo
If yes, please specify which Child Life Department you are donating to:
Estimated Value
Nemours Children’s Health Alliance is the philanthropic arm of Nemours Children's. Your contribution is tax deductible as provided by the law. No goods or services have been provided by Nemours Children’s in return for your gift.

Disclosure: If your gift cannot be used, we reserve the right to donate it to another deserving charity

If you have any questions, please contact the appropriate office below:

Wilmington, DE: 302.651.4828

Orlando, FL: 407.650.7050

Pensacola, FL: 850.503.2781

Jacksonville, FL: 904.697.4103
Location benefiting from this gift:*

Nemours Children’s Hospital, DelawareNemours Children’s Health, JacksonvilleNemours Children’s Hospital, FloridaNemours Children’s Health, Pensacola
Well Beyond Medicine
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Record of Donated Goods

THIS IS YOUR RECEIPT and will be emailed to the address provided.

Well Beyond Medicine