Honor a Caregiver

Honor an exceptionally compassionate caregiver with a donation to the Schwartz Center. We'll add your caregiver's name to our Compassionate Caregiver honor roll, and for a gift of $100 or more, we will also send a Compassionate Caregiver Certificate on your behalf. Caregivers are nourished and re-energized when they know their work is valued!

Your donation in honor of a caregiver goes directly to our programming and is tax deductable to the extent

allowed by law.

Donation Information

If your gift is $100 or more, the Schwartz Center will send a Compassionate Caregiver Certificate.

Amount: / □ / $50.00
□ / $100.00
□ / $250.00
□ / $500.00
□ / $1,000.00
□ / $5,000.00

□ other $ ______

Designation (please check one):

Where it is needed most

Schwartz Center Rounds

Medical Director

Additional Information

Corporate:□This donation is on behalf of a company or organization:

______

Anonymous:□I prefer to make this donation anonymously

Name as you would like it in our donor report: ______

How did you hear about the Schwartz Center? Website

Event

Attended Schwartz Center Rounds

Blog

A friend

Billing Information

Title: ______First Name: ______Last Name: ______

Address: ______

City: ______State:______ZIP:______Country:______

Phone:______

Email:______

Cardholder’s Name: ______

Card Type (check one): □ American Express □Mastercard□ Visa

Credit Card Number: ______Card Expiration: ______

Caregiver Information

□ Please send Compassionate Caregiver Certificate (if checked please complete section below) Name:______Organizaton:______Address:______City: ______State: ______Zip: ______Country: ______

Matching Gifts

My company will match my gift

Company: ______

If your company matches gifts, please complete the required form from your HR Department and mail it along with your donation to:

The Schwartz Center for Compassionate Healthcare

PO Box 417597

Boston, MA02241-7597

Or if you would like to Fax your form:617-643-6123

If you have any questions about giving, please call us at617-643-4067, or email .