Nursing School Donation Form
Please complete the form to make donations.
Full Name
*
First Name
Last Name
Company Name
E-mail
*
example@example.com
Phone Number
*
Type of Donation
Nursing Lab Equipment
Building Expansion
Support Future Nurses
General Support
Non-monetary Donations (this option is to donate supplies and equipment)
Comments - Please feel free to leave a comment.
Equipment and Supply List - Please feel free to donate any items
- Full Body Manikin (3) - Manikin Toro (3) - Life size Skeleton (1) - Scale (1) - Headwall System (6) - Manuel BP cuffs - Stethoscopes - PPE
Donation Amount
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next
( X )
USD
Description
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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