Please do not enter a decimal in your donation amount.
Step 1
Donation Information
Donation Amount $
Gift Designation
Please do not enter a decimal with your donation amount.
Donation Amount
Other Amount
Donation Frequency
For the duration of
For the duration of
Number of Years
Please describe how often you
would like to make payments:
Donation Total:
Personal or Corporate Gift?
Corporation Name
Step 2
Donor Information
First Name*
Middle Initial
Last Name*
Spouse Name
Address 2
Zip Code*
Daytime Phone*
Home Phone
Donor Listings, please list me/us as
(e.g Mr. Joe Smith, Mr. and Mrs. Joe Smith)
Comments or Questions
Make Donation Anonymous
I would like to make this donation in honor or memory of someone else.
Step 3
Billing Information
Payment Type
Name On Card*
Card Type*
Card Number*
Security Code/CCV*
Expiration Date
Card Number
Expiration Date

Download ACH form - please print and mail with a voided check)

My Company Matches My Contribution
Please enter your company's name and mail your completed matching gift form to Bozeman Health Foundation.
Step 4
Tribute Information
Tribute Type
Full Name
Please send an acknowledgement to:
Bozeman Health Foundation will send notification of your gift to the name and address listed below.
Address 2
Zip Code
Please tell us why you chose to honor this person/caregiver:
May we contact you about this gift in honor of your chosen person/caregiver?
Is this person your physician, nurse, other hospital employee, family member or friend?

"Tree of Memories"

For memorial gifts of $250 or more, we welcome you to inscribe a leaf for the "Tree of Memories".

Leaf Type:
Inscription (70 characters available, including spaces and punctuation)

"Footprint Order"

In recognition of your gift of $250 or more, we will display a silver medallion, imprinted with a footprint, the honoree's name and birth date. Memorial tributes will be recognized in gold. These medallions will be displayed in the Bozeman Deaconess Hospital Family Birth Center. You will also receive a beautifully etched glass replica of ypur medallion.

Footprint Color
Baby's Name
Baby's Lbs
Baby's Ozs
Baby's Birth Date
Please send the glass replica to: