Help sustain the highest quality hospice and bereavement ...

Help sustain the highest quality hospice and bereavement care in our community while honoring someone important to you who has passed.

Your monthly gift will help sustain vital unreimbursed hospice care for adults and children, complementary therapies including music and pet therapy, grief and loss counseling and youth grief camps, and unique programs designed to support Veterans at the end of life.

When you join you will receive a welcome packet and recognition as a Circle of Remembrance monthly donor in our Annual Report.

You may choose from a variety of secure, easy and convenient automatic-giving options and will receive an annual

RCLE O

CI NCE

F REM

"There's rosemary, that's for remembrance. Pray you, love, remember." ? William Shakespeare

EMBRA

Yes! I would like to join Hospice of the Chesapeake's Circle of Remembrance with a monthly gift of:

q $25

q$15

q$10 (minimum)

qMy best monthly gift: $_____________

In memory of: ______________________________ My Name: ______________________________ My Address: ______________________________

______________________________ My Email: ______________________________ My Telephone: ______________________________

qDebit card qCredit card q Visa qMC qAmex qDiscover Name on card:___________________________ Card number: ______________________ Expiration date: ________ Charge on q1st or q15th day of each month q I have arranged for _________________________ [Bank Name]

to make automatic monthly payments on

(which day each month): _____________ q Please call me to arrange monthly debits from my bank account or to discuss other means of payment.

You may notify us at any time if you would like to stop your automatic monthly payments. Contact the Hospice of the Chesapeake Foundation at 443.837.1500 or email foundation@.

HOSPICE OF THE CHESAPEAKE FOUNDATION ? John & Cathy Belcher Campus 90 Ritchie Highway ? Pasadena, Maryland 21122 | 410.987.2003 ?

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