Donation Form

 

cropped-Logo_HKH_50th_Fin_unzipped.jpg

stethascope-heart

 

Yes! I Will Join Hamakua-Kohala Health in Improving the Health of Our Community!

Your generous gift is tax deductible.



via PayPal

Thank you for joining with us to accomplish great things!

We have outgrown the space available at the clinics in Hamakua and North Kohala and are in need of funds to rebuild our clinics and cover the increasing costs of operations. Your support is key to helping our kupuna, keiki and young families to find vital primary and preventative health care, including substance abuse and mental health services.

 

Here is my gift of: $25 ____ $50 ____ $100 ____ $250 ____ $500 ____

$1,000 ____ $2,000 ____ $5,000 ____ $30,000 ____ Other $____

____I have enclosed my check payable to Hamakua-Kohala Health.

____I prefer to use my credit card.    Visa     Mastercard     AMEX

Card number:____________________Expiration date:________CVC:_________

Name on card:___________________________________________________

Signature:______________________________________________________

Information:

My phone number is: (______)_______________________________________

My address is:___________________________________________________

My email address is: _______________________________________________

Hamakua-Kohala Health has been here for you for 50 years, and needs your help now to be here for 50 more. Thank you for thinking of our community.

 

Please make a copy of this form for your tax records. A receipt will be mailed.

Please feel free to contact us with any questions at: donate@hamakua-health.org

http://www.hamakua-health.org/donate/

If you have trouble accessing the donation amount field on the Hamakua-health.org donation page through PayPal (field is grayed out), please update your web browser, OR cut and paste the website address (URL) into the address field in another web browser (ie: from Firefox to Internet Explorer). Thank you for your generous contribution!