* required information
Donation
Donation Amount
:* $
Donor Designations
Select a designation for your contribution*
 
Donor Information
This gift is made by an:* Individual
Organization
Are you an Orlando Health Team Member?:* Yes
No
Team Member ID #:
Title:*
First Name:*
Middle Initial:*
Last Name:*
Suffix:
Company Name:
Job Title:
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Country:*
Phone:*
Email:*
Check here if you would like to receive future information from Orlando Health via email: Opt In
How did you find out about us?:
This donation is made in recognition or in memory of:
Mail a letter on my behalf to the following person. (Must include name and address.):
Comments:
Donate anonymously: I prefer to make my donations anonymously
Payment Information
Payment Method
:*
:*
:*   Explain
Credit Card Type:*
                  
Credit Card Expiration:*
Billing Information
If the billing information is the same as the contact information check this box.
If not please fill out the information below:
:*
:
:*
State:
:
:*
Country:*
Matching Gift Information

Many companies match philanthropic gifts to nonprofit organizations for their employees, retirees and family members. Matching gifts can double or even triple your gift to the APMC Foundation. Click here to search the matching gift database to see if your and/or your spouse's company will double or even triple your gift. To initiate a matching gift, obtain the appropriate form, complete the form and send it to: APMC Foundation, Attn: Matching Gifts, 3160 Southgate Commerce Blvd., Suite 50, Orlando, FL 32806. Some forms can also be submitted online.


Will this donation be potentially matched?
If you know the following information regarding the matching gift, please complete.
Company Name:
Matching Gift Amount:$

About Your Donation

The Arnold Palmer Medical Center Foundation is a 501(c)(3) organization. Our federal tax ID# is 59-2244943. All donations are tax-deductible to the extent permitted by law. A receipt will be sent by email.

Contributions to Arnold Palmer Medical Center Foundation are deductible for income tax purposes to the extent allowed by law. The Foundation recommends that you consult with your tax advisor concerning allowable deductions.

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE 800-435-7352 WITHIN THE STATE OF FLORIDA. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE. ORLANDO HEALTH FOUNDATION IS A REGISTERED CHARITABLE ORGANIZATION (CH577).

By clicking Submit,
your credit card will be processed