Memorial Gift

Memorial Gift

Once gifts are received the TCMH Healthcare Foundation will notify the designated family with a letter that a gift has been made. The letter includes the names and address of donors. No amounts are ever given. The donor receives a thank you note and tax receipt for their generosity. Gifts can be directed to any area of Texas County Memorial Hospital including TCMH Hospice of Care, Emergency Room, Obstetrics, and other departments. Memorials may also be designated to support the Foundation’s scholarship fund or in some instances, used to establish a scholarship in memory of a loved one.

Note: For online donations, you will be redirected to PayPal’s website. You do not have to have a PayPal account to donate.

or print the form below and mail to:

TCMH Healthcare Foundation
1333 S. Sam Houston Blvd.
Houston, MO  65483

To designate the TCMH Healthcare Foundation for your loved one’s memorials or seek additional information, please contact the office at 417-967-1377 or by email.

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IN LOVING MEMORY OF

________________________________________________________

Address for ackowledging the gift to a family member or appropriate party.

Name ___________________________________________________

Address_________________________________________________

City________________________________State________Zip______

A memorial contribution is made: (Please Check One)
____ To be used by the Foundation as best meets the hospital’s needs.
____ Foundation Scholarship Fund
____ Foundation Capital Building Fund
____ Hospice of Care
____ Other TCMH Departments (Please specify or contact Foundation for more info)

With the Deepest Sympathy of (Donor’s Name) ________________________________________________________

Address ________________________________________________

City ________________________________ State _______Zip_____

Phone ________________  Email address ______________________

$500 _____     $250 _____     $100 _____     $50 _____       $25 _____ 
Other $____________

_____ Check enclosed  _____ Credit Card        ______Visa     _____MasterCard

Card # ____________________ Expiration __________

Signature ____________________________________

Name as it appears on card __________________________________________

The TCMH Healthcare Foundation is a 501C 3 non-profit organization and gifts are tax deductible per IRS regulations.