Foundation Accounts and Online Donations – Foundation

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Online Donations

Thank you for your interest in the St. Alexius Foundation. To make your contribution, please complete the following information.

If you have any questions, please contact the Foundation at 701-530-7065.

The amount of your gift is confidential. All contributions are tax deductible. A copy of this page may be printed for your records.

Online Donation (Items marked with an * are required.)
I would like my gift to go to:

Personal Information
* First Name: * Middle Inital:
* Last Name:
Spouse Name:
* Home Phone Number:
Work Phone Number:
* Mailing Address:
* City:
* State: * Zip Code:
Email Address:
Contact

Please contact me about making a planned gift to the
St. Alexius Foundation.

Anonymous Gift

Grateful Patient and Families Program

This donation is being made in honor of:

(birthday, anniversary, event)

This donation is being made in memory of:

(deceased person)

Indicate the name and address of the person you wish to be notified of this honor/memorial gift:
Credit Card Information
 
* Payor’s Last Name:
* First Name:
Middle Initial:
* Mailing Address:
* City
* State: * Zip Code:
* Phone Number:
* Credit Card Type Accepted:

MasterCard

Visa

DiscoverCard
* Credit Card Number

(xxxxxxxxxxxxxxxx)

* Security Code On Credit Card:

(xxx)

* I/We Donate the following Amount: $
Comments:

Cash contributions to St. Alexius Foundation are also welcome.
Please make checks payable to “St. Alexius Foundation”, complete the Printable Donation form and mail to:

St. Alexius Foundation

PO Box 5510

Bismarck, ND 58506-5510

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