Emory Online Giving
Emory Online Giving » Billing » Review » Finish

Making a gift online is fast, easy, and secure. Using the form below, please select the areas you would like to support. Required fields are marked with an asterisk (*). Once complete, please click the "Next" button at the bottom of the page. Click here to download a form and mail in your gift.

Select Gift Amount:
Total Gift Amount:
$ required
Select Gift Designation(s):
Select Gift Designation(s)
Designations required
Center for Palliative Care Gifts
Specific Designation:

Is this payment against a pledge? (Check for YES):
Are you using a corporate card for this gift? (Check for YES):
If so, please provide company name:
Honor/Memory Instructions:
If you choose to make your gift in honor or memory of someone, please include the name of the person to be honored or remembered, and the name and address of the person that you would like us to notify of this gift in the fields below. Please note that without complete address information, we are unable to send a gift notification.
This gift is:

Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Please mail a notification of this honor/memory gift to:
Prefix:
First Name
Middle Name:
Last Name:
Suffix:
Street Address:
City:
State:
Zip/Postal Code:
Country:
Personal Information:
Prefix:
First Name:
required
Middle Name:
Last Name:
required
Suffix:
Former/Maiden Last Name:
Home Address Street 1:
required
Home Address Street 2:
City:
required
State:
Country:
Zip/Postal Code:
Email:
Phone Type:


required
Preferred Telephone:
required
(Phone Number Format: 123-456-7890)
Your Affiliation with Emory (Check all that apply):
I am a(n):





Spouse/Partner Information:
Spouse/Partner Prefix:
Spouse/Partner First Name:
Spouse/Partner Middle Name:
Spouse/Partner Last Name:
Spouse/Partner Suffix:
Spouse/Partner Maiden/Former Name:
I prefer not to share joint gift credit with spouse/partner.