Oregon Hospice and Palliative Care Association

Donations - Secure Online Donation Form

You will receive via email a confirmation and receipt of your contribution. If you do not see your receipt, please check your spam or junk mail folder. You may also email mccauley@oregonhospice.org or call 503.890.7027 for donation/payment troubleshooting.

Campaign/Fund Information
Campaign/Fund *	Tributes, Memorials or Select a Different Fund

Donation Information
Donation Amount *	OTHER: $
Payment Method *	Check/Money Order Credit Card
Donation Type *	One-Time Donation Recurring Monthly Donation (until cancelled)
My donation is
Name of Person(s) Donation is in Memory/Honor of
First/Last Name of Person(s) Acknowledgment Card will be sent to
Mailing Address for Above (for having acknowledgment card sent via USPS)
OR Email Address for Above (for having acknowledgment card delivered via email)
Special Message for Acknowledgment Card (optional)
Join Our Mailing List *
What is 3 + 4? *	What is 3 + 4?
Donor Comments

Donor Information

First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
State	(Reset)
Postal Code*
Phone *

Billing Information
[ Click here if billing address is the same as donor address ]
Name on Card *
Card Type *
Card Number *
Card CVV Num *	What is this?
Exp. Date *	/
Organization
Address *
Address Cont.
City/Town *
Country *
State	(Reset)
Postal Code*
Billing Phone *

The Cardholder stated above has authorized this payment. If this payment is part of a recurring series of payments, the Cardholder understands the terms and amounts of those recurring payments, and authorizes payment for each of them. Cardholder consent will expire once all scheduled recurring payments have been processed, or if all future recurrences are cancelled. The Cardholder acknowledges that specific payment dates may vary. Examples include, but are not limited to: payment dates falling during weekends, holidays, or during system outages. In order to facilitate the processing of those recurring payments, stored credentials will be used. Those stored credentials will only be used to process payments that are part of this series of recurrences. In order to use those stored credentials for any other payment, Cardholder re-authorization will be required. In the event that a consent agreement must be modified, the new agreement will be sent to the email address associated with the invoice.

The Cardholder understands the terms and authorizes the payment(s).

Saving your donation details...

Please do not click the back button on your browser or navigate away from this page.

Contact Us

Connect