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Donation Amount
*
$500
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Improve mental healthcare access for local youth and children through grants
$250
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Boost scholarships for local nurses
$100
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Provide a young person or parent in need with one appointment with a therapist
$50
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Train three physicians to better understand youth and children’s mental health
$25
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Connect moms to support for pregnancy and postpartum depression/anxiety
$
Donation Schedule
One Time
Monthly
Business donation
This is a business or organization donation
Your Name
*
Prefix
First Name
Last Name
Suffix
Organization Name
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If donation is being made by a business or other organization
Contact Name
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First Name
Last Name
Your Email
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Your Phone
Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
I would like to designate my gift for:
*
Where it is needed most
Children's Behavioral Health Grants
Mental Health Copay Assistance
Pregnancy & Postpartum Mental Health
Clinical Supervision Collaborative
Training and Continuing Education
Nursing Scholarships
Anonymous
I wish to keep my gift anonymous.
My preferred name for gift acknowledgement
Example: Jane Doe, John and Jane Doe, Drs. Jane and John Doe, etc.
Is this a tribute gift?
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in honor of
in memory of
Tribute Information
Tribute Name
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First Name
Last Name
Please notify:
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Address Line 1
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City
City
State
State/Province
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May we keep you updated on how your gift is at work?
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Yes, please add me to the mailing list
No, thank you
Lift Up Circle
I'd like to lear more about the Life Up giving circle for friends of LOHF who pledge $250 annually.
Personal Message
Do you have any questions about work of the LOH Foundation or anything you would like to share?
Add 3% to my total amount to help cover the payment processing fees