Donation (Dev)

Gift Dedication

I would like to dedicate this gift.

Type of dedication

Please select a dedication type.

Honoree Name

Name is required

Address

Address is required

City

City is required

State

State is required

ZIP Code

ZIP Code is required

Country

Country is required

Please notify the following person of my gift without specifying the amount.

Name

Name is required

Address

Address is required

City

City is required

State

State is required

ZIP Code

ZIP Code is required

Country

Country is required

Gift Amount

$50 $100 $250 $500 Other amount

Please select a donation amount.

See if your employer will match your donation!

Your Information

I would like to give on behalf of an organization.

Organization Information

Organization Name

Organization name is required

Phone

Phone is required

Email is required

Address

Address is required

City

City is required

State

State is required

ZIP Code

Zip is required

Country

Country is required

I would like the gift to remain anonymous.

Donor Information

First Name

First name is required

Last Name

Last name is required

Phone

Phone is required

Email is required

Address

Address is required

City

City is required

State

State is required

ZIP Code

Zip is required

Country

Country is required

Keep in Touch with By the Bay Health

Would you like to hear from us?

We would like to contact you occasionally to share about what we are doing in the community, invite you to events, and update you on special projects. Please opt in to receiving these via the options below. You can withdraw your consent at any time.

All Email Communications

Yes

All Mail Communications

Yes

To learn how we collect and use your information, please read our privacy policy.

Payment

Choose payment method:

Use a credit card or wallet

I would like to cover the transaction fees for my donation.

Your total donation amount:

$0.00

(415) 927.2273

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Gift Dedication

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Your Information

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Donor Information

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Would you like to hear from us?

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