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© 2012 Camarillo Hospice Corporation, 400 Rosewood Ave., Suite 102, Camarillo, CA • (805) 389-6870

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We Appreciate Your Support!

As a non-profit organization, we are grateful for all donations and gifts. If you are interested in helping us provide compassionate care to those facing a life-limiting illness, or grieving the loss of a loved one, please print this form and
mail it with your generous gift amount, or click the button at the bottom of this page to make a secure, online donation:

Please accept my donation of:

___ $50 ___ $100 ___ $250 ___ $500 ___ $1,000 ___ $5,000 Other:____________________________

Please publish my donation:

___ In memory of: _________________________________________________________________________________________

___ In honor of: ___________________________________________________________________________________________

Send acknowledgement to: __________________________________________________________________________________

___ I have included Camarillo Hospice in my will (we would like to thank you).

___ Send me information on how to include Camarillo Hospice in my estate planning.

Name ____________________________________________________________________________________________________

Address: __________________________________________________________________________________________________

Address 2__________________________________________________________________________________________________

City_________________________________State___________Zip_________E-mail_____________________________________

Camarillo Hospice is a 501(c)(3) non-profit organization; tax ID Number 95-3347061. Please send your gift to: Camarillo Hospice, 400 Rosewood Avenue, Suite 102, Camarillo CA 93010-5933. To contact Camarillo Hospice please call us at 805-389-6870, or e-mail at: info@camarillohospice.org

To make a secure, online donation through PayPal, please click on the button below (you don't have to have a PayPal account):