Supporting The Doctors Kienle Center for Humanistic Medicine Endowment
Your Donation
Donation Option
*
One-Time
Donation Amount
*
Maximum Amount to Donate (Optional)
$
Total
Is this donation in honor of someone?
Yes
No
Is this donation in honor or memory of someone?
No
Honor
Memorial
This gift is in honor of:
Their address is:
This gift is in memory of:
We should notify (name and address):
If yes, please provide the name and address of the person you are honoring
Is this donation in Memory of someone?
Yes
No
If yes, please provide the name and address of the person you would like to be notified
How would you like to receive your tax receipt?
*
Email
Mail
Corporate Giving
Individual Gift
Gift on behalf of my company
Employer Name
Company Name
Payment
Payment Method
*
{accountType} ending in {accountLastFour}
{accountType} ending in {accountLastFour}
Choose a different way to pay
Contact Details
Been here before?
Login to your account
to prefill the fields below with your information.
Email Address
*
Password
*
Cancel
Forgot Password?
Email Address
*
Cancel
Name
*
First Name
Last Name
Show my name as (Optional)
Email Address
*
Title
*
Dr.
Mr.
Mrs.
Ms.
Mx.
Donate with Credit Card
Donate {amount}
Donate with Bank Account
Venmo
$
USD
AUD
EUR
GBP
CAD
USD
/
Yes! I’d like to cover processing costs. (
per month
per year
per
)
Repeat Donation for
*
Months