Donation Form

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I am interested in being a Covenant Hospice Volunteer. I want to provide for Covenant Hospice in my will or other estate-planning document. I would like to become a member of the Covenant Society: Diamond $5,000 or greater* Emerald $2,500 - $4,999* Ruby $1,000 - $2,499* Sapphire $500 - $999* Not at this time I am interested in regular giving through recurring payments . Please contact me. I would like to donate the amount of
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Process your donation now using Verisign's secure credit card transaction processing or print this form and mail your gift to:

Covenant Hospice
5041 N 12th Ave
Pensacola, FL 32504

You will receive an acknowledgement of your gift. Gifts to Covenant Hospice, a 501(c)(3) not-for-profit organization, are tax deductible.

Thank you for supporting Covenant Hospice!

Covenant Hospice, Inc. operates in the state of Florida as a 501(c)3 charitable organization and is registered with the Florida Dept. of Agriculture & Consumer Services. Covenant Hospice does not engage outside solicitors, and one hundred percent (100%) of contributions are received by Covenant Hospice and its foundation. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

For additional information, call the Florida Dept. of Agriculture and Consumer Services at 1-800-435-7352. Registration # SC-04450.

* Total annual contributions. More details...