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Tax deductible contributions in support of the Hospitalís care efforts, the Calvary Fund, can be made using our secure on-line form. To use our on-line donation, fill in the following information as it appears on your credit card billing statement.

Click here to see if your employer offers a matching donation program.

* required information
Select Gift Frequency
I would like to make a one-time gift for the following amount:
:* $
I would like to make a recurring gift.
Gift Amount* # of Payments Payment Frequency Total Gift Amount
$ X = $
NOTE: This transaction will count as the first payment toward your total gift amount.
Donor Information
Suffix:
Title:
First Name:*
Middle Initial:
Last Name:*
Email:*
Company Name:
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Phone:
Fax:
Country:
Business Phone:
Cell Phone:
Job Title:
Payment Information
:*
:*
:*   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:*
Make your donation in remembrance of a loved one or to honor a special individual or event
In Honor Of:
In Memory Of:
Notification Name:
Notification Address 1:
Notification Address 2:
Notification City:
Notification State:
Notification Zip:
Special Instructions:
The staff of the Fund is prepared to assist donors to structure a gift that supports the Hospital and meets the personal, financial and investment needs of the donor. If you would like assistance using this form, or wish to use an alternate method of making a donation, please contact:

Calvary Fund
Phone: (718) 518-2077
E-mail: avalitutto@calvaryhospital.org

***Please note: You must type the Captcha shown below in the space provided in order for your credit card to be processed. THIS IS REQUIRED. Type the two words in lower case and do not put a space between the two words.
Type the characters you see in the picture below:*
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