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Malta House of Care Donor Information
Your Name
*
Prefix
First Name
Last Name
Suffix
Donor name(s) to be acknowledged if different from above
Preferred Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Verify Email
*
Preferred Phone Number
Donation
Amount
*
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Is this a Memorial or Honorary Gift?
*
No
Yes, Honorary Gift
Yes, Memorial Gift
In Honor/Memory of...
Prefix
First Name
Last Name
Suffix
Dedication
Name of Person to notify about this gift
First Name
Last Name
Address of person to notify
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email of person to notify
Verify Email
Keep gift anonymous?
Yes
Matching Gifts
Many companies will match gifts from employees and retirees, thereby increasing your gift to Malta.
My company has a Matching Gift program, and I will submit the form.
My company has a Matching Gift program, but I am unsure about how to proceed; please contact me.
Organization/Employer
Add 3% to my total amount to help cover the payment processing fees