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Please complete this Tribute Gift Form and mail to:

    American Red Cross of Rhode Island
    105 Gano Street
    Providence, RI 02906
    Attn: TRIBUTE GIFT

For any questions regarding tribute gifts, please contact Kristin Wieber, Chief Philanthropy Officer, at [email protected] or call 401-831-7700 x106.

..............................................................................

Donor's Name:

___________________________________

Donor's Address:

___________________________________

City, State, Zip:

___________________________________

Phone:

___________________________________

E-Mail:

___________________________________

 

 

Name of Person You are Honoring:

___________________________________

Name of person receiving special notification card (if different):

___________________________________

Recipients's Address:

___________________________________

City, State, Zip:

___________________________________

Reason for making tribute gift (death, birthday, etc.):

___________________________________

 

 

Amount of gift (this information is confidential):

$__________

 

 

Payment Type:

__ Check     __ Credit Card

If Credit Card:

__ MC  __ VISA  __ AM/EX   __Discover

Card Number:

___________________________________

Expiration Date:

___________________________________

Signature:

___________________________________

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© Copyright 2002-2004 American National Red Cross. All rights reserved.
American Red Cross of Rhode Island 105 Gano Street Providence, RI 02906
(401) 831-7700 TOLL FREE 1-800-842-1122

 


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