GLENWOOD ONLINE DONATION
Donor Information
Title:
Mr
Mrs
Ms
Miss
Rev
Dr
Pres
Rev Dr
First Name
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MIddle Name or Initial
Last Name
*
Organization (If Applicable)
Phone Number
Organization Phone Number
Address
*
City
*
State
*
Zipcode
*
Giving Circles: Gifts of $100+ are included in one of our Support Levels and highlighted in our Annual Report
Life Enrichment Fund Support Levels
*
Please choose a category:
Gift Amount between $1 to $99
Society of Stephen Circle $100+
Matthew & Jane Smith Founders Circle $250+
The Herbster Circle $1,000+
Robert & Eleanor Diller Inaugural Circle $2,500+
The President’s Circle $5,000+
The Ruth F. Parker Circle $10,000+
Donation Amount
*
$
Donation Frequency
*
One Time
Monthly
Quarterly
Annual
If your donation frequency is more than one time, please indicate the total amount you would like to pledge
Do you want to designate your gift to a specific purpose?
*
No
Yes
If Yes, please choose from the list below or type your designation in here
Designation Choices
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All United Church Homes (unrestricted)
Benevolent Care Endowment Fund
Quellhorst Leadership Education Endowment Fund
Chapel Hill Community
Fairhaven Community
Four Winds Community
Parkvue Community
Patriot Ridge Community
Trinity Community
Glenwood Community
Harmar Place
All Housing
Housing: Specific Community
Tribute Information
In Memory Of
In Honor Of
Tribute Name
Do you want us to send a letter to the family on your behalf notifying them of your gift? (no dollar amount will be stated in the letter)
No
Yes
If Yes, please indicate the name and address of the family member you wish us to notify:
Additional Comments
Payment Options
Please select the following
*
By Credit Card to pay online
By Check to mail in donation
By Phone
By Mail: Please mail your check and printed form to: United Church Homes 170 E. Center St PO Box 1806 Marion, OH 43301-1806
By Phone: The Advancement Department (740) 223-2032 or Toll Free (800) 837-2211 ext. 2032
Your Email Address
*
Total
$
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