Our Way of Saying "Thank You" - Department of Philanthropy

As an expression of our gratitude for individuals such as yourself, we created the Jefferson Washington Society—and it is our pleasure to invite you to be a part of this select group of friends and donors. This is our way of simply saying “thank you” for investing in our hospital and we hope that you will accept this recognition with the same goodwill with which it has been offered.

As a member of the Jefferson Washington Society, we will have the opportunity to assist you when you need a helping hand. Services and amenities of the Jefferson Washington Society can be found here.

We invite you to complete the enrollment form below at your earliest convenience. Once received, we will mail you a Jefferson Washington Society membership card.

Jefferson Washington Society

Your Full Name(Required)

Membership(Required)

Yes, I/We accept membership into the Jefferson Washington Society

No, I/We will not be utilizing the services of the Jefferson Washington Society

Member 1 Name

Date of Birth

Enter Email Confirm Email

Mobile Phone Number

Home Phone Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Member 2 Name

Date of Birth

Enter Email Confirm Email

Home Phone Number (if different from above)

Mobile Phone Number

Address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Membership Confirmation

By checking this box, I/we accept membership in the Jefferson Washington Society at Hartford Hospital for the individuals listed on this form. In doing so, Hartford Hospital has my/our permission to be notified when the individuals listed above are hospitalized for the sole purpose of offering the amenities and services of the Jefferson Washington Society program.

Agree