Required Information
Donor Name First: Last:
Address
 
City, State, Zip
Email
Phone
Contributed Amount $
Credit Card Type
Credit Card Number
Exp. Date /
Name on Card
Optional Information

Tribute Gift is:

  
In memory of
In honor of
For the speedy recovery of
On the occasion of
To our Annual Fund  
Name of Person To Whom Tribute Is Being Paid:
Send an Acknowledgement to:  
Name First: Last:
Address
City, State, Zip

To mail in a donation, print this form and mail it with your check to:
The Gathering Place
23300 Commerce Park
Cleveland, Ohio 44122

If you do not want to submit this form online, you may fill it out, print it, and fax it to us at (216) 595-9581. You can also make your donation via telephone by calling (216) 595-9546.