Donation Pledge Card
A 501 (c) (3) non-profit, charitable organization.
I want to help improve end-of-life
Levels of Support care and pain management in
$50 $250 Indiana.
$75 $500 I would like to volunteer with
$100 $1,000 IHPCO.
$150 Other $
I would like to receive more
information about IHPCO’s
Special Gifts programs.
Honor Gift, in recognition of:
Name and Address of person(s) to receive information about special gift:
City: State: Zip:
Phone:( ) Email:
10 West Market Street Suite 1720 Indianapolis, Indiana 46204
Phone: (317)464-5145 Fax: (317)464-5146