EFOHCA Donation Form

Your donation goes to support the efforts of the Educational Foundation of OHCA and our mission of scholarship giving and continuing education of professionals in long term care.

Name*

Facility/Company

Address*

City*

State *

Postal Code*

Contact Phone Number*

Contact Email*

Type of Donation*

Memorial Contribution

Contribution to create a new scholarship

Contribution to support general scholarship program

Contribution to support general education programs

Bed Assessment

Memorial Contribution honoring

Name Scholarship for $25,000

Premier Scholarship for $50,000

Platinum Scholarship for $100,000

Donation Amount*

Credit Card Type*

Credit Card Number*

(no dashes):

Name on Card*

Expiration Month

Year*

The Educational Foundation of OHCA is a 501c3 tax-exempt, charitable organization. Your donation is tax deductible and a receipt acknowledging your gift will be sent to the email listed for your tax records.

Thank you!

Elevating the Post-Acute and Long Term Care Profession

EFOHCA Donation Form

Your donation goes to support the efforts of the Educational Foundation of OHCA and our mission of scholarship giving and continuing education of professionals in long term care.

Elevating the Post-Acute and
Long Term Care Profession