Automatic Monthly Donation | Benefis Health System Foundation Online Payment

Monthly Donation Details

This information is required

Gift Amount (This is how much you would like to give on a monthly basis, not your total contribution.)*

Other Amount*

How Many Months Would You Like for Your Donation to Recur?*

Gift Designation*

Other Program*

Gift is From (first / last name or business organization name)*

Anonymous Donation*

Tribute Information (Optional) - Honor or Remember a Special Person

This Gift Is

Tribute's Title

Tribute's Name

First Last

Would You Like Us To Send An Acknowledgment Letter?

*If 'yes', an acknowledgement of your gift will be sent to the individual, or to a family member. The amount of your gift will not be mentioned.

Acknowledgement Sent to Title:

Acknowledgement Sent to Name:

First Last

Address (For Mailing Letter):

Street Address Address Line 2 City State ZIP Code

Message to Include:

Relationship to Remembered/Honored Person:

Company Matching Gifts (Optional)

Company Matching:

Employer Contribution

My employer has agreed to match my contribution

Name of Employer:

Please send your company's matching gift form to: Benefis Health System Foundation PO Box 7008 Great Falls, MT 59406-7008 OR [email protected]

Planned Gift Information

I would like information about how a gift of $1,500 or more can qualify for the Montana Endowment Tax Credit and provide substantial tax saving. Please contact me to discuss Planned Giving options.*

Yes, I am interested
No, I am not interested

Additional Information

Comments (Optional)

Mailing List

Please add me to your mailing list

Billing Details

This information is required

Name*

First Last

Email*

Phone*

Billing Address*

Street Address Address Line 2 City State ZIP Code

Type of Credit Card*

Secure Credit Card

Card Holder*

Card Number*

Card Expiration*

Card CVV*

Total

$0.00