Giving to Children's


Please help us accurately process and acknowledge your donation:

Print clearly

Complete the entire form

Provide a fair market estimate of your donation. Per IRS regulations, Children’s is not able to value your donation for you.

Donor Information

Date: ____________
Donor (Individual, Organization or Group): _____________________________________________

Parent/Guardian Name (if donor is under 18): ___________________________________________

Organization/Group Contact Name: ___________________________________________________

Address: _________________________________________________________________________

City, State Zip: ____________________________________________________________________

Phone Number: ___________________________________________________________________

Value of Gift: _____________________________________________________________________

Description of Gift: ________________________________________________________________

_________________________________________________________________________________

This donation is given in Memory of: Honor of:

_________________________________________________________________________________

If Children’s is unable to use your donation do you want it returned to you? Y N

Check here if you do not require a receipt/acknowledgement for your donation.



Please send completed form to Children’s Foundation:

Mail Stop 35-115A or

Fax: 651-855-2850