Legacy Stone Gift for Connecticut Hospice

CONNECTICUT HOSPICE

LEGACY STONE GIFT: Make a Donation in Honor or in Memory
Tribute Type*

in honor ofin memory of
Honoree Name*

First NameLast Name
Legacy Stone Tribute Gift*

$250
Make my gift go further. Increase my gift by 3% to help cover transaction expenses.

Yes I will cover the 3% fees
Transaction Fee
Donation Tally
ZIP CODE IS REQUIRED

in the bottom-right credit card details field

Donation Total

USDDescription

Input Your Printed Message Below.

Messages are limited to three lines, with a maximum of 13 characters (including spaces) per line.
Line 1
Max 13 characters, including spaces.
Line 2
Max 13 characters, including spaces.
Line 3
Max 13 characters, including spaces.
Would you like to notify a friend or family member of this tribute including the legacy stone message?*

By emailBy postal mailNo thanks
Display my name?*

YesNo
Display donation amount?*

YesNo
Recipient Email*
example@example.com
Recipient Name*

First NameLast Name
Recipient Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Donor name(s) or nickname(s) to display in notification. (Defaults to name on credit card input.)
ex. Aunt Kathy and Uncle George or The Clark Family ... etc.
My company will match this gift?

Yes, they will match.
Please upload your company's matching gift form.

Browse Files

Cancelof
If your organization requires a W-9, please contact our Development Office at 203-315-7684 or send request to donations@hospice.com

The Connecticut Hospice, Inc. is a not-for-profit 501(c)(3) organization. Donations are tax-deductible. Our federal tax ID number is 06-0878822.
Your Information
Your Name*

First NameLast Name
Email*
example@example.com
Receive email updates from Connecticut Hospice?

Yes, subscribe me to the newsletter.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Should be Empty: