Request edit access
Donate in honor of someone special
We are SO grateful for your donation and wanting to honor a special someone! After your online donation, please fill out the following form. We will mail/email the honoree a certificate letting them know that you have made a donation in their honor and that they have made it possible to celebrate a hospitalized child. *Certificate will NOT be sent unless donation was made. Please include ALL information necessary to mail/email acknowledgment or we will NOT be able to process.
Your Name *
Your answer
Honoree Name (First & Last) *
Your answer
Would you like your acknowledgment: *
Honoree E-Mail Address
Your answer
Honoree Mailing Address (include street, city, state & zip code)
Your answer
Occassion celebrating *
Would you like to add a personalized message?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms