GIFTS TO HONOR OR REMEMBER: THE DR. DIANE BARTON COMPLEMENTARY MEDICINE PROGRAM HEALING GARDEN The Cooper Foundation is an independent, charitable, tax-exempt 501 (c)(3) organization dedicated to supporting Cooper University Hospital and Cooper University Health Care. Name Address City, State, Zip Phone Email DEDICATION PLAQUE PRICING ☐ PAVER $ 250 PLEASE RECOGNIZE MY GIFT AS FOLLOWS In Honor of On the Occasion of In Loving Memory of Name or message as you would like it to appear in the garden (40 character limit): PLEASE NOTIFY THIS INDIVIDUAL/ FAMILY OF MY GIFT (gift amount will remain confidential) Name Address City, State, Zip PAYMENT INFORMATION ☐ Enclosed is my check. (Make payable to The Cooper Foundation) ☐ Please charge my credit card: ☐ Visa ☐ MasterCard ☐ Discover ☐ AMEX Name on Card Card Number Exp. Date Security Code Signature ☐ Please accept my donation as payroll deduction. Signature (Cooper employees only) MATCHING GIFT Many employers will match an employee donation. Please contact your Human Resources Office for the appropriate form and return it to us with this form. Matching Gift Form: □ Enclosed □ Will arrive later Company Name PLANNED GIVING ☐ Please send me information about remembering Cooper University Health Care/ MD Anderson Cancer Center at Cooper in my will. ☐ I have already included Cooper University Health Care/ MD Anderson Cancer Center at Cooper in my will. Please mail this completed form to: The Cooper Foundation Sheridan Pavilion 3 Cooper Plaza, Suite 500 Camden NJ 08103 If you have questions, please call 856.342.2222. To make a giſt online, visit foundation.cooperhealth.org. Located at MD Anderson Cancer Center at Cooper Voorhees, the healing garden has a scenic design to allow nature to enhance the healing process. It serves as a retreat meant to bring joy, comfort and peace to patients and visitors.
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GIFTS TO HONOR OR REMEMBER: THE DR. DIANE BARTON COMPLEMENTARY MEDICINE PROGRAM HEALING GARDEN
The Cooper Foundation is an independent, charitable, tax-exempt 501 (c)(3) organization dedicated to supporting Cooper University Hospital and Cooper University Health Care.
Name
Address
City, State, Zip
Phone
DEDICATION PLAQUE PRICING
☐ PAVER $ 250
PLEASE RECOGNIZE MY GIFT AS FOLLOWS
In Honor of
On the Occasion of
In Loving Memory of
Name or message as you would like it to appear in the garden (40 character limit):
PLEASE NOTIFY THIS INDIVIDUAL/ FAMILY OF MY GIFT (gift amount will remain confidential)
Name
Address
City, State, Zip
PAYMENT INFORMATION☐ Enclosed is my check. (Make payable to The Cooper Foundation)
☐ Please charge my credit card: ☐ Visa ☐ MasterCard ☐ Discover ☐ AMEX
Name on Card
Card Number
Exp. Date Security Code
Signature
☐ Please accept my donation as payroll deduction. Signature (Cooper employees only)
MATCHING GIFTMany employers will match an employee donation. Please contact your Human Resources Office for the appropriate form and return it to us with this form.
Matching Gift Form: □ Enclosed □ Will arrive later
Company Name
PLANNED GIVING☐ Please send me information about remembering Cooper University Health Care/ MD Anderson Cancer Center at Cooper in my will.
☐ I have already included Cooper University Health Care/ MD Anderson Cancer Center at Cooper in my will.
Please mail this completed form to:
The Cooper FoundationSheridan Pavilion
3 Cooper Plaza, Suite 500Camden NJ 08103
If you have questions, please call 856.342.2222. To make a gift online, visit foundation.cooperhealth.org.
Located at MD Anderson Cancer Center at Cooper Voorhees, the healing garden has a scenic design to allow nature to enhance the healing process. It serves as a retreat meant to bring joy,
comfort and peace to patients and visitors.
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