Gift & Payment Information

Children's Ambassadors Membership Form

Thank you for your interest in joining the St. Louis Children's Hospital Ambassadors. Children's Ambassadors are young professionals from across the city who are committed to improving the lives of patients and families at St. Louis Children's Hospital through volunteering, donating and spreading awareness. Please click here to learn more or sign up below!

Gift Options

Gift Types

One Time Gift

Monthly Gift

Field Is Required Select Gift Amount:

$500.00

$500 Annual

$41.67

$41.67 / mo

Other:

Enter amount

Yes, automatically repeat this gift every month.

Donor Covers Transaction Fee

Yes, I would like to cover the transaction fee.

Yes, this is a tribute gift.

Tribute Gift Type:

Honoree First Name:

Honoree Last Name:

Yes, I would like to send a card by mail.

Yes, I would like to send an e-card. Yes, I would like to send an e-card.

No, no notification is needed.

Send a mailed notification of your gift

Send an e-card notification of your gift

Recipient email addresses:

Select an e-card:

E-card Subject:

Notification Recipient First Name:

Notification Recipient Last Name:

Address:

City:

State/Province:

ZIP/Postal Code:

Country:

Message:

Personal Details

First Name:

Last Name:

Email Address:

Phone Number:

Billing Address

Street 1:

Street 2:

City:

State/Province:

ZIP/Postal Code:

Country:

Yes, I would like my gift to be anonymous.

Keep me informed via email.

Payment Options

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

Would you consider including a gift to St. Louis Children's Hospital in your estate plan?

Remember Me