Donate Now First Name: Last Name: Address: City: State: Email: Name as you wish to appear in donor recognition publications: Choose a set amount from below or write in your own: Custom Donation Purchase basic care supplies – $86 Heal the emotional scars of children – $118 Provide an acute care visit for a sick child – $141 Provide one full year of acute care – $705 Promote an infant’s healthy growth and development – $846 If choosing ‘Custom Donation,’ how much do you want to donate? $ This gift is made: In Memory Of (optional) In Honor Of (optional) Name on Gift (optional): Please send an acknowledgement of this tribute gift to: Name: Address: