Gift of Remembrance

Make a Gift

A Gift of Remembrance is an expression of love, compassion and respect for someone special. To make a memorial gift, please complete the following information.

In Memory of:

Amount:

Make my gift:

Unrestricted - Where the need is the greatest
Restricted to (indicate below):

Please send acknowledgement of this gift to the following person. The amount of gift will not be disclosed.
(The Acknowledgement fields are optional)

Name:

Address:

City:

State:

Zip:

Please add any additional information you would like to share about this gift:

First Name:

Last Name:

Address:

Address 2:

City:

State:

Zip Code:

Phone Number:
(like ###-###-####)

Email Address:
(like jsmith@example.com)

Method of Payment:

MastercardVISA

Credit Card Number:

Expiration Date:
(like ##/##)

Name on Card:

Check your information then click "Submit".

Contributions to the Memorial Medical Center Foundation are tax deductible as allowed by law.

You may mail this form to:

For more information, please call (217) 788-4700.

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Make a Gift

Gift of Remembrance