Text Box: Text Box: A Gift of Tribute Text Box: Remember Someone Special. The Jefferson Health Care Foundation Gift of Tribute provides and excellent opportunity to remember those living or deceased, whose lives have touched the lives of everyone around them. You are invited to make a tax-deductible gift to the Jefferson Health Care Foundation. Your gift can be in memory of someone who has passed away, or you may choose someone who is celebrating a birthday, anniversary, graduation or wedding. When you make a Gift of Tribute, you will receive a prompt acknowledgement of your generosity and the honored person or family will be notified of your thoughtful tribute in their honor or memory. The amount of the gift is kept confidential. Text Box: Enclosed is my gift of $ ________________ Honoree’s Name (if applicable) _________________________________________________________ In Memory Of In Honor Of Anniversary Birthday Other _______________________________________________________ Send acknowledgment of my gift to: Name: _____________________________________________________________ Address: ____________________________________________________________ City: ________________________________________ State: ______________ Zip: ________________ My Name is (donor): _________________________________________ Address: ____________________________________________________________ City: _______________________________________ State: _______________ Zip: __________________ Text Box: Please complete all requested information pertaining to your gift. Enclose the form with your check (made payable to Jefferson Health Care Foundation) and mail to: Office of Development Attn: Stephanie Diedericks 300 South Preston Street Ranson, West Virginia 25438