Your Check Donation Is So Appreciated! - Lily Home Health & Hospice Care serving Wisconsin

If you would like to make a donation by check, please complete the form below and send your check to the following address:

Lily Hospice
W63N545 Hanover Ave
Cedarburg, WI 53012

Name: *

First

Last Name *

Last

Email

Company Name:

Is your donation made to honor an individual or family?

Yes

No

We would love to be able to send an acknowledgment card of your gift to the family of the individual or family you are honoring with your donation.

Name of person being honored/memorialized

Name of family/individual to be notified

Address of family/individual to be notified

City

State/Province

Zip/Postal

Is this a Corporate donation? *

Yes

No

Donation Frequency: *

One Time Donation

Monthly

Annually

Donation Amount: *

Donation Comments:

Thank you for your generosity!