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HIGHLIGHTS

Help keep the beacons of light shining at the shore and ensure the finest healthcare services are always available at Shore Memorial Hospital.

Membership Application

Join now!

To become a member of the Lightkeeper’s Society, please complete and submit the form below. For more information, please contact us at: (609) 653-3800.

* Denotes required information

First Name:

Last Name:

Spouse:

Company:

Address:

Apt.

City:

State:

Zip Code:

Daytime Telephone:
(including area code)

- * (cell phone preferred)

Fax:
(including area code)

Email:

My gift is to be anonymous.

Charter Member: Please accept my pledge donation of $5,000 per year for three consecutive years.

Annual Member: Please accept my pledge donation of $5,000 for one year.

Amount of Gift: $

Name on Card:

Card Number (no spaces or dashes):

Expiration Date:	Security Code

Comments:

You will receive an email confirmation of your Lightkeeper’s Society membership application and donation.

All donations are tax deductible as allowed by law.

Thank you for your support of the Lightkeeper’s Society at
Shore Memorial Hospital.

Shore Memorial Health Foundation
One East New York Avenue • Somers Point, NJ 08244-2387 • 609-653-3800

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