Charitable Outreach

Charitable Outreach Section

Name
Address
City
State
Zip
Home Phone
Work Phone
E-mail
Yes! I'd like to give a gift and visit to a nursing or personal care home patient this Christmas holiday.
Please match me with patients
Preferred Nursing Home/Patient (if known):

Will children accompany you on this visit? Yes No
Is this a business or group project? If yes, name of business/group:
No, I am unable to visit a patient, but would like to send embroidered, cotton PRESENTS FOR PATIENTS^® throw(s) for patient(s) at $30 each.
I would like to make an additional donation to PRESENTS FOR PATIENTS^®:
Amount
Type of Payment
Account Number
Expiration Date
Name as it appears on card
How did you learn about PRESENTS FOR PATIENTS^®?

Checks can be mailed with completed form.

Please make check payable to PRESENTS FOR PATIENTS and send to the address below

Mail to:
St. Barnabas Charities
PRESENTS FOR PATIENTS
5850 Meridian Road
Gibsonia, PA 15044