Dell Children's Trust Annual Gift Thank you for supporting Dell Children's Medical Center! You're joining a group of individuals, couples, families, organizations and other supporters dedicated to helping the young patients of Central Texas receive the highest quality of care--regardless of their ability to pay. Members of Children's Trust will collectively vote to grant their pooled funding to serve the program of their choice at Dell Children's. Gift Information Field Is Required Enter A Gift Amount: $20,000.00 Hope Granters $15,000.00 Miracle Makers $10,000.00 Platinum Circle $5,000.00 Premiere Circle $2,500.00 Family Benefactor $1,500.00 Ambassador Non Membership Donation Enter amount Company Match for Membership Enter amount Donor Information Title: Mr. Ms. Mrs. Miss Dr. Required First Name: Last Name: Suffix: Sr. Jr. II III IV V Required Street 1: Street 2: City: State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required ZIP/Postal Code: Email Address: Yes, I would like to receive communication from this organization. If this gift is on behalf of an organization or business, please provide the name here: Honoree Information Yes, this is an honor or memorial gift Honor Gift Type: In Memory of In Honor of Required Honoree Title: Mr. Ms. Mrs. Miss Dr. Required Honoree Name: Message Body: Notification Recipient Title: Mr. Ms. Mrs. Miss Dr. Required Notification Recipient Name: Notification Recipient Street 1: Notification Recipient Street 2: Notification Recipient City: Notification Recipient State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required Notification Recipient ZIP/Postal Code: Yes, include the gift amount in the message. Process Cancel