Giving Opportunities

In Support of Susquehanna Health's
Providence Health System Foundation and
The Williamsport Hospital Foundation

PAYMENT OPTION    Credit Card    Pledge    Check
First Name  Last Name 
Address  City 
Zip  Phone 
E-Mail 

Name(s) as you wish to be recognized  
OR    I / we wish to remain anonymous  

Please Direct My Contribution to One of the Following:
Providence Health System Foundation
570-320-7460		 The Williamsport Hospital Foundation
570-320-7463
Greatest Need Greatest Need
Gatehouse Continuing Medical Education
Hospitality Inn™ Community Health Improvement
Kathryn C. Lundy Breast Health Center Hospitality Inn™
Mother Pauline Susquehanna Heart Center
MVH Skilled Nursing Other  
Susquehanna Cancer Center
Providence House
Friends Acknowledging Nursing (FAN)
Susquehanna Home Care & Hospice
Sister Jean Mohl Nursing Award Fund
Other  
Contribution Amount  $  .00

I / we have included Providence Health System Foundation in my / our will. Please send me / us information on Heritage Circle  

I / we have included The Williamsport Hospital Foundation in my / our will. Please send me / us information on Legacy Society  

Honor / Memorial: (Choose one if appropriate)
This gift is in memory of     in honor of 

Please Notify: (Name and Address)
   

North Central Pennsylvania Health System Foundation, d/b/a The Williamsport Hospital Foundation and Providence Health System Foundation are non-profit 501(c)(3) organizations. Contributions are deductible to the fullest extent allowed by law. The official registration and financial information of the Foundations may be obtained from the PA Department of State by calling toll-free within PA 1.800.732.0999. Registration does not imply endorsement.