Yes! I Will Join Hamakua-Kohala Health in Improving the Health of Our Community!
Your generous gift is tax deductible.
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:___________________________________________________
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: email@example.com
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!