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Make a Gift

Thank you for contributing to a healthier region through your gift to Genesis Philanthropy. You are invited to contribute to an existing population health fund by completing this online form, and/or visit with our staff about creating a Named Fund by calling 563-421-6860. Thank you!

* Denotes required fields

Donor Information

* Donor Salutation

* Donor First Name

Donor M.I.

* Donor Last Name

Spouse Salutation

Spouse First Name

Spouse M.I.

Spouse Last Name

* Address

* City

* State Example: IL

* ZIP Code Example: 12345

Home Phone Example: 123-123-1234 x123

Email

* Gift Amount Example: 1234.56

* Frequency

One-time gift
Recurring gift

* Gift Type

Standard Gift
Gift in loving memory of
Gift in honor of

* My/Our Gift is Anonymous

Yes
No

Gift Information

* This gift is applied to the following regional fund:

Area of Greatest Need
Doctor's Day
Family Connects Program
Grief Support
Metabolic Syndrome Initiative
Scott County Mental Health Court
Gene and JoAnn Waddell Regional Fund for Hospice and Cancer Care

I/we are interested in learning about including Genesis in our will, bequest or estate plan. Please mail information to the address above.

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