Thank You for Your Donation

Thank You for supporting Great Lakes Hemophilia Foundation!

Please complete the following information:


  • Please type in the donor name presentation you would like used for recognition purposes (e.g. Jan & Bill Smith)
  • Contact Phone Number
  • Will your gift be matched by your or your spouse's employer?
    Yes   No   Will Inquire
  • Specify whether you would like your gift directed to:
    Wherever it will do most good
    Patient Financial Assistance
    Camp Program
    Education/Support Services
    Scholarship Fund
  • Specify whether this gift is
    In Memory of
    In Honor of
    On the occasion of
  • Who should we notify about your memorial/honor gift?

  • Please check this box if you have included GLHF in your estate plans

    Would you like information about including GLHF in your estate plans? Yes No
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