Box Butte Health Foundation
STEP 1
Donor Info:
Country*
(None Selected)
Australia
Canada
New Zealand
United Kingdom
United States
State / Province*
Address*
City*
State / Province*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
STEP 2
Select Fund & Gift Amount
Fund*
Golf Tournament
Scholarships
Jane's Closet
Unrestricted
Giving Tuesday
Donation Amount*
$25
$50
$100
$250
Other $
Donation Frequency*
One Time
Annually
Semi-Annually
Quarterly
Monthly
Weekly
STEP 3
Dedication
Dedication Name
Dedication Type
(None Selected)
In Memory Of
In Honor Of
Send notification of dedication to:
Name
Address
City
State
Postal Code
STEP 4
Payment
Amount*
$
After you complete this form, select
SUBMIT
to enter your payment details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
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