and return it to us, and we will share it with that caregiver. Mark Jaffarian [FirstName] [MI] [LastName] You may also make a gift of gratitude in recognitio 1115 Main St [Address1] [Address 2] cognition of the Ann nurse, doctor, aide, or staff who gave you or your family the extra care and attention when yo Lagasse Haverhill, MA 01830-1406 [City] [State] [zipcode] when you needed it most. Member and Chair Community AJH has made a way for people like you and me to Anna Jaques Community Health Foundation Board d me to do so by establishing the Grateful Patient Fund. Your gift enables AJH to recruit, train and retain w Dear Mark, [firstname], etain Yes wonderful giverslike forto critically return the attached tear off card w , Ann,care I would make aneeded gift ofstaff gratitude to support the positions. best carePlease possible at Anna Jaquestear-off Hospital. f card with your gift today! April 2, 2012 Sincerely, Enclosed is my pledge for: Yes, Ann, I would like to make of gratitude to support theout best R Ecare C Every N possible T Gfortunate I F T S Tat O Anna Awe N Nare. A Jaques J A Q U E SHospital. : “Sometimes it takesa agift calamity in our lives to point how o $300 is $150 o Other:$__________ Enclosed my pledge for [ask1], [ask2], $________other other Enclosed iso my$250 pledgeo for q $125, q $100, q[ask3], $75, q $_________ Mark Jaffarian [FirstName] [LastName] I arrived in a wheelchair, no longer able to walk. I cannot begin to[MI] describe the pain Please update your contact informa�on: Payment Op�ons Please update your contact information: 1115 Main St [Address1] [Address 2] Please update your contact information: I had been experiencing for months. The team of medics atFY2013 Anna Jaques was veryFY2012 Check made payable to Anna Jaques Hospital is enclosed Ann Lagasse Haverhill, MA[zipcode] 01830-1406 [City] [State] Mark Jaffarian capable and professional. They made my time priormytocredit the operation [FirstName] [MI] [LastName] Charge card: Visacomfortable MasterCard and AMEX Discover Community Member and Chair Kathy C. Stevens Ms. Jane Q. Donor FY2011 FY2010 reassuring. Within 24 hours, I was undergoing rehabilitation... with no pain! I stayed 1115 Main St [Address1] [Address 83 Academy Rd 78 River Road South2] Anna Jaques Community Health Foundation Board for01845-4001 three days at Anna Jaques and I can’t thank them enough for the excellent Your Hospital: Haverhill, MA 01830-1406 Card Number North Andover, MA Putney, VT 05436 FY2009 n Board [City] [State] [zipcode] The Campaign Dear Mark, [firstname], Telephone: 978treatment 809 9830I received.” Telephone:_________________________________ for Anna Jaques [phone____________________________________________] Email:______________________________________ Anne Teel, patient, Newburyport Telephone: E-mail: _______________________________ laste gift:former 4/18/2012 Date of last gift: 4/18/2012 Expira�on Date CCV# givingto FY2012: $150.00of the Daily News, Total FY1012: Email: (letter the editor [e-mail____________________________________________] Yes, Ann, I would like to make a gift of gratitude to su “Sometimes takes January 2012) Anna Jaquesonfiscal year is Oct 1stit -Sept 30th a calamity in our lives Thank you! Name as it appears Card Enclosed is pledge for [ask2], $________ o point Area Greatest Need o Breast Center o Other______ Enclosed is my my pledge for [ask1], q $125, q $100, q[ask3], $75, q $_________ de to support theofout best care possible at Anna Jaques Hospital. The data above was compiled onaNov 15th, 2012 ur lives to how very fortunate we Care are. I arrived in wheelchair, no longer able ot _______other other www.ajh.org/giving ______ Please update youryour informa�on: Options Anna Foundation Please update contact information: r able toPayment walk. IJaques begin to describe pain Icontact had been experiencing for months. The t Ifcannot you orCommunity a loved one Health hasthe received special care at AJH, please share that story with us. Our Authorized Signature 25 Highland Avenue, Newburyport, MA 01950 Payment Op�ons s. The team of medics Anna Jaques wastreasure very Health Mark Jaffarian capable and professional. [FirstName] □ Check madeat payable to AJH Community Or, you may give[MI] at www.ajh.org/giving www.ajh.org • 978-463-1176 health care professionals such stories of grateful patients and families. Send us ashare letterthis orThey made my t To leave aon-line gift[LastName] in your will, simply Check made payable to Anna Jaques Hospital is enclosed AF412HF Foundation enclosed ade my time prior the operation and sentence with your attorneyWithin or financial planner: reassuring. 24caregiver. hours, I was underg Main St write aisnote thecomfortable back of the tear off card and return 1115 it to us, and we will that Charge mytocredit card:on Visa MasterCard AMEX Discover [Address1] [Address 2] share it with undergoing rehabilitation... with no pain! I stayed □ Charge my credit card: for threeordays at Anna Jaques Haverhill, MA$01830-1406 “I bequeath % of my estateand I can’t [City] [State] [zipcode] I can’t thank them enough for the excellent received.” □Card VisaNumber □You Master Card □ AMEX □a Discover may also make gift of gratitude in recognition ofTelephone: the doctor, aide, orIstaff whoFoundation, gave you to nurse, Anna Jaques Community Health 978treatment 809 9830 [phone____________________________________________] 25 Highland Ave., Newburyport, MA 01950.” most. _ _ _ _or_your _ _ _family _ _ _the _ extra _ _ _care _ _and _ /attention _ _ _when _ _ you needed E-mail:it_______________________________ _] Expiration Date Card Number CCV# Anne Teel, former patient, Newburyport [e-mail____________________________________________] Expira�on Date CCV# □ I have included Anna Jaques Community Health (letter to the editor of the Daily News, _] AJH has made a way for people like you and me to do Thank soFoundation byyou! establishing in mythe will.Grateful Patient Fund. Name as it Your appears on card January 2012) gift AJH to recruit, train and retain wonderful care givers for critically needed staff Name as it appears on enables Card Anna Jaques Foundation Iftoday! you orCommunity a loved one Health has received special care a positions. Please return the attached tear-off tear off card with your gift 25 Highland Avenue, Newburyport, MA 01950 on l care atSignature AJH, please share that story with us. Our www.ajh.org • 978-463-1176 health care professionals treasure such stories of gr Authorized Signature 649 AF1212 Thank you! Or, you patients may give on-line at www.ajh.org/giving es of grateful and families. Send us a letter or write a note on the back of the tear off card and ret Sincerely, AF412HF P P and return it to us, and we will share it with that caregiver. You may also make a gift of gratitude in recognitio or your family the extra care and attention when yo cognition of the Ann nurse, doctor, aide, or staff who gave you Lagasse when you needed it most. Member and Chair Community AJH has made a way for people like you and me to Anna Jaques Community Health Foundation Board d me to do so by establishing the Grateful Patient Fund. Your gift enables AJH to recruit, train and retain w etain Yes wonderful giverslike forto critically return the attached tear off card w , Ann,care I would make aneeded gift ofstaff gratitude to support the positions. best carePlease possible at Anna Jaquestear-off Hospital. f card with your gift today! Sincerely, Enclosed pledge Yes, Ann,isI my would likefor: to make a gift of gratitude to support the best care possible at Anna Jaques Hospital. o $100 is ofor $50[ask1], Other:$__________ Enclosed my pledge [ask2], $________other other Enclosed iso my$75 pledge for qo $125, q $100, q[ask3], $75, q $_________ Please update your contact informa�on: Please update your contact information: Please update your contact information: Mark Jaffarian [FirstName] [MI] [LastName] Ms. Susan Drake Mr. John Q. Donor 1115 Main St 2] [Address1] [Address 200River Market StSouth Apt 111 78 Road Haverhill, MA 01830-1406 Lowell, MA 01852-1827 Putney, VT 05436 n Board [City] [State] [zipcode] Telephone: 978 809 9830 Telephone:_________________________________ [phone____________________________________________] Email:______________________________________ Telephone: E-mail: _______________________________ RECENT GIFTS TO ANNA JAQUES: Payment Op�ons FY2013 FY2012 Check made payable to Anna Jaques Hospital is enclosed Ann Lagasse Charge my credit card: Visa MasterCard AMEX Discover P Community FY2011 Member and Chair FY2010 Anna Jaques Community Health Foundation Board Your Hospital: Card Number FY2009 The Campaign for Anna Jaques Date of last gift: 6/8/2010 Expira�on Date Email: [e-mail____________________________________________] CCV# Last Annual Fund Gift: $50.00 Yes, Ann, I would like to make a gift of gratitude to su Anna Jaquesonfiscal is Oct 1st-Sept 30th Thank you! as it appears Card year Enclosed is my pledge for [ask1], [ask2], $________o o Area ofbest Greatest o Breast Care Center o Other______Name Enclosed is my pledge for q $125, q $100, q[ask3], $75, q $_________ de to support the care Need possible at Anna Jaques Hospital. The data above was compiled on Nov 15th, 2012 _______other other www.ajh.org/giving ______ Please update your contact informa�on: _] Payment Options Anna Jaques Community Health Foundation 25 Highland Avenue, Newburyport, MA 01950 Payment Op�ons □ Check made payable to AJH Community Health www.ajh.org • 978-463-1176 Check made payable to Anna Jaques Hospital is enclosed Foundation is enclosed Charge my credit card: Visa MasterCard AMEX Discover □ Charge my credit card: □Card VisaNumber □ Master Card □ AMEX □ Discover ____ ____ ____ ____ __/__ Card Number Expira�on Date Expiration Date ___ CCV# CCV# Please update your contact information: Mark Jaffarian [FirstName] Or, you may give[MI] www.ajh.org/giving To leave aon-line gift[LastName] inatyour will, simply share this AF412HF sentence with your attorney or financial planner: 1115 Main St [Address1] [Address 2] Haverhill, MA$01830-1406 “I bequeath or % of my estate [City] [State] [zipcode] to Anna Jaques Community Telephone: 978 809 9830 Health Foundation, [phone____________________________________________] 25 Highland Ave., Newburyport, MA 01950.” E-mail: _______________________________ _] on Or, you may give on-line at www.ajh.org/giving [e-mail____________________________________________] □ I have included Anna Jaques Community Health Thank you! Foundation in my will. Name as it appears on card Name as it appears on Card Signature Authorized Signature Authorized Signature Anna Jaques Community Health Foundation 25 Highland Avenue, Newburyport, MA 01950 www.ajh.org • 978-463-1176 Thank you! AF412HF 650 AF1212
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