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Donation Information
Amount:	$ 1,000.00 $ 500.00 $ 250.00 $ 100.00 Other $     *
Designation:	Area of Greatest Need of Bethesda North Hospital Harold & Eugenia Thomas Heart Center Bethesda CARES Fund Bethesda Women's Circle of Giving Liu Xiaoming Scholarship Fund Mary Jo Cropper Family Center for Breast Care Healing Touch Program Medical and Education Research Patient Emergency Fund Team Member Emergency Fund TriHealth Fitness and Health Pavilion Assistance Thomas Wilburn Scholarship Fund Wilma Brown Scholarship Fund Other
Other	*
Additional Information
Type of gift:	One-time gift Recurring gift
Frequency:	Weekly Monthly Quarterly Annually On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
Corporate:	This donation is on behalf of a company
Anonymous:	I prefer to make this donation anonymously
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What is your relationship to TriHealth?:	<Please select> Team Member Former Team Member Retired Team Member I do not work for TriHealth	*
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Title:	<Please select> Dr. Drs. Father Miss Mr. Mrs. Ms. Pastor Rabbi Sister	*
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Matching Gifts
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Tribute Information
Type:	in honor of in memory of	*
Honor/Memorial Name:		*
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