Pledge/Donation Form

Pledge & Donation Form

With your pledge or donation to the Seashore Gardens Foundation, together we will continue to provide services to residents who are in need of care.

Please complete this form, then print and mail it with your donation to Seashore Gardens Foundation, 22 W. Jimmie Leeds Road, Galloway Township, New Jersey 08205.

Or, you may call Heather Scism, Fund Development Coordinator, at 609-748-4614 to make a secure contribution over the phone with your credit card. Your generosity is greatly appreciated.

In support of the Seashore Gardens Foundation,

I/we pledge the sum of $ to be paid

at this time

monthly

quarterly

semi-annually

annually for a period of years

beginning

or as follows:

This donation should assist in funding the following program:

Senior Assistance Effort (supports resident health care programs and services)

The Richard Simon Center for Alzheimer's

Grateful Patient Program

Summer Sizzler Youth Scholarship

Resident Program/Trip

Commemorative

Inscription:

4-Hole Putting Green

Player Piano

Tree of Life - Leaf ($100)

Tree of Life - Rock ($275)

Inscription:

Wish List Item

Other

Form of Payment:

Check (Please make checks payable to Seashore Gardens Foundation)

Credit Card
	Expiration Date: /

Credit Card Number:
Signature:
3-4 Digit Verification #	(on reverse side of card)

My gift is anonymous:

Yes No

My gift is made in honor of:

Acknowledge to:

Address:

City, State, Zip:

My gift is made in memory of:

Acknowledge to:

Address:

City, State, Zip:

My information:

Name:

Address:

City, State Zip:

Phone:

Email:

I would like information on naming Seashore Gardens in my will.

Contributions are tax deductible to the extent provided by law. If you have any questions, please contact the Office of Fund Development by calling 609-748-4614 or email scismh@seashoregardens.org.