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Donation of Good or Services
We are grateful for all donations of goods and services, known as “gifts in kind,” and we want to be sure to recognize you and/or your organization for your kindness. Please complete this form to tell us more about you and your donation.
Gift in Kind Donation
Gifts in Kind
First Name
(Required)
Last Name
(Required)
Company/Organization
Address
Address
Street Address
City
State
Alabama
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American Samoa
Arizona
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Texas
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Virginia
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Armed Forces Americas
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Armed Forces Pacific
Zip
Phone
(Required)
Email
(Required)
Please check here if this gift is anonymous.
If this box is unchecked, Virtua Health may include donor name in recognition listings or publications.
Tell Us About Your Gift/Donation
Provide a description of your donation (please be specific).
This gift is intended for:
Virtua Marlton Hospital
Virtua Mount Holly Hospital
Virtua Our Lady of Lourdes Hospital
Virtua Voorhees Hospital
Virtua Willingboro Hospital
Virtua Health & Wellness Center Camden (including CASTLE)
Virtua Health & Wellness Center Berlin (including CASTLE)
Other, please specify below
Gift is intended for:
Total Estimated Value of Your Gift
Additional Information
Please share any additional information that you would like us to know.
Phone
This field is for validation purposes and should be left unchanged.