Gift to the Foundation
Cascade Valley Hospital Foundation

Please Designate My Gift For:

___ Capital Equipment Fund
___ Unrestricted - Use where needed most
___ Other: _________________________

___ I prefer not to have my donation acknowledged


Enclosed is my gift of $_________ to CVHC Foundation.

Donor: ___________________________________________________________

Address: __________________________________________________________

City: _____________________________________________________________

In Memory of: ______________________________________________

In Honor of: ________________________________________________

Send card to: ______________________________________________________

Address: __________________________________________________________

City: ____________________________ State: _______ Zip: ________________

Please sign card as follows: ___________________________________________
Make check payable to: Cascade Valley Hospital Foundation

Complete form and mail to:
C.V.H.F.
Attn: Heather Logan
330 S. Stillaguamish
Arlington, WA 98223