Championing Health Care in Indiana since 1921.

Donate

Friends of Indiana Hospitals Contribution Club Levels

$5,000+ 1898 Society

$2,500 – $4,999 Champions Club

$1,000 – $2,499 Ben Franklin Club

$500 – $999 Chairman's Circle Club

$350 – $499 Capitol Club 

$150 – $349 Helen H. Barrett Club

Please note that this is a two step process.

Please complete the form below for IHA records.
Once you submit the form below you will be directed to a PayPal donation portal.
It is important that you add the donation amount at the top of the PayPal donation payment processing page along with your payment information in order for your donation to be processed completely.

Donation (Step 1 of 2)

Name *

Occupation/Title *

Home Address *

Zip Code *

Phone Number *

City, State *

Affiliation City *Hospital Affiliation, City

Hospital Employee *Are you a hospital employee?

Employer *If not a hospital employee, provide employers name

Donation Amount *

AHA PAC *

I DO NOT want a percentage of my
contribution given to support the AHA PAC

I would like a percentage of my
contribution given to support the AHA PAC

For questions, please email Melissa Vise or call 317-423-7731.

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PARTNER SITES:

© Indiana Hospital Association

500 N Meridian Street, Suite 250, Indianapolis, IN 46204 \\ 317-633-4870

QUICK LINKS:

© Indiana Hospital Association

500 N Meridian Street, Suite 250, Indianapolis, IN 46204 \\ 317-633-4870