registration form - cooley dickinson hospital1.) round up at the register ask customers to round up...
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How it Works & PromotionYou, your team, or business select how you would like to participate in Cooley Cares for Kids. Once we receive your registration, we will meet with you to customize the program for maximum impact and exposure. You support programs for local kids and we promote your business’s participation through these channels. It’s that simple!
Participant Promotion Through:• Social Media exposure• E-Blast to 2500 donor database• E-newsletter to 2000 CDHC employees• Website exposure • Press Release • Business on poster • Media Partnerships exposure• Highlighted in newsletter
Ways You Can Participate 1.) Round Up at the registerAsk customers to round up $1, $3, or $5 at the register.
2.) Donate a portion of proceedsPick a week, day or the month of May to donate a portion of gross sales proceeds.
3.) Sell plush bears Sell plush bears for a $10 suggested donation on their own or with a bounce back program.
4.) Become A Community kidshealth championSupport the program with a tax deductible charitable gift of $150, $250, $500, or other.
My/Our business is interested in providing healing care to kids in our community! We would like to participate through:
___ 1.) Round Up at the register
___ 2.) Donate a portion of proceeds
___ 3.) Sell plush bears
___ 4.) Community kids health champion with a tax deductible gift of : q $150 q $250 q $500 q Other: $_____
If you check one of the above, we’ll contact you to set up a personalized planning meeting.
Business/Org: _____________________Contact Name:_____________________Address: _________________________City: ____________State: ____ Zip: ____E-mail:___________________________Daytime phone:_____________________
Please return this form by April 1st to Jennifer Margolis by:
Mail: Cooley Dickinson Development Office PO Box 329 Northampton, MA 01061-0329
Fax: (413) 582-2942
Email: [email protected]
Questions? Call Jennat (413) 582-2684
Registration Form
How You Can Bring Healing to Kids in this Community
When you participate in Cooley Cares for Kids, your support directly impacts:
• Cooley’s Pediatric Rehabilitation Program, where physical, occupational and speech therapy help children heal and reach their full potential.
• The Emergency Department where specially trained physicians and nurses are available 24/7 to treat everything from life-threatening illnesses to broken bones and stitches in child-friendly care spaces.
• Babies and families in our Childbirth Center to ensure a healthy beginning of life. From newborns to teenagers,
your participation helps provide careto over 9,000 children who are served
by Cooley Dickinson every year.
Interested in Learning More about Cooley Cares
for Kids?
Please contact Jennifer Margolis:
(413) 582-2684
1/2017
Cooley Cares for Kids
As a Massachusetts General Hospital affiliate, Cooley Dickinson remains an independently licensed, not-for-profit, tax-exempt, charitable health care provider that maintains
its own board of trustees, medical staff, community connections, and fund-raising activities with a clear mission
to serve our patients and communities with exceptional, compassionate, and personalizedc care.
www.cooley-dickinson.org/giving