Gift & Payment Information

2021 St. Louis Children's Employee Giving Credit Card Form

St. Louis Children's Hospital Foundation funds patient-centered programs and services not funded by normal hospital operations. The Employee Giving Campaign is an opportunity to participate in our culture of philanthropy and support those programs and services that support our patients and families. Please join us!

If you have any questions, please contact Hannah Brenton at Hannah.Brenton@bjc.org or 314.286.1270.

PLEASE NOTE: To help keep everyone safe and doing our part to halt the spread of COVID-19, St. Louis Children's Hospital Foundation staff will be working remotely until further notice.

2021 St. Louis Children's Employee Giving Credit Card Form

St. Louis Children's Hospital Foundation funds patient-centered programs and services not funded by normal hospital operations. The Employee Giving Campaign is an opportunity to participate in our culture of philanthropy and support those programs and services that support our patients and families. Please join us!

If you have any questions, please contact Hannah Brenton at Hannah.Brenton@bjc.org or 314.286.1270.

PLEASE NOTE: To help keep everyone safe and doing our part to halt the spread of COVID-19, St. Louis Children's Hospital Foundation staff will be working remotely until further notice.

Field Is Required Choose a Donation Amount

$26.00

$26

$50.00

$50

$100.00

$100

$250.00

$250

$500.00

$500

Other Amount

Enter amount

$15.00

$15

$20.00

$20

$25.00

$25

$30.00

$30

$35.00

$35

Other Amount

Enter amount

Gift Information
One-time
Monthly

Select a Gift Duration

Total Gift 0.00

Field Is Required Please direct my gift to

Use my gift where it is needed most.

Direct my gift to:

Write in Designation

Employee Details

Employee ID# (10 digits, located on the back of your badge)

Title

Floor or Suite

Department

Department Leader

Are you an alternate worksite employee?

Alternate worksite employees' t-shirts will be mailed to the billing address as noted below.

Facility where employee works

This radio option selects the field value from the following selection list.

This radio option selects the field value from the following text input field.

Mailstop Number (required for campus mail, AWS employees type n/a)

T-shirt size (To receive a shirt, please make a minimum gift of $26.)

How will I receive my t-shirt?

All shirts will be sent either via Campus Mail or USPS for AWS employees the fourth week of each month.

Billing Information

Title

First Name

Last Name

Address 1

Address 2

City

State

Zip Code

Country

Phone

Email

I would like my gift to be anonymous

Keep me informed via email

Payment Information

Payment Method:

Credit Card

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Check Information