Online Donation

THANK YOU!

Every dollar you generously donate makes an impact to those in York Region with Alzheimer's disease and other dementias.

 

If you would like to make your donation by phone, please call 1-888-414-5550.

Here's my gift of:

Donation Amount*
  • $1,000
  • $500
  • $250
  • $100
  • $50
  • Other $

Contact Information

Country*
Email*
Confirm Email*
Phone*

An electronic tax receipt in the name of the donor will be sent to the email address provided for one-time gifts. Please enter a valid email address.


 

(Optional) Please make my Gift In Honour of:
(Optional) Please send an acknowledgement of my donation to: (Name)
Acknowledgement Address
Acknowledgement City
Acknowledgement Province/State
Acknowledgement Postal Code/Zip Code

When sending out acknowledgement letter on your behalf we will not disclose any financial information. 


Payment Information

Amount*
$
Payment Type
We only accept credit/debit card payments. After you complete this form, select Submit to enter your card details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
Additional Comments

Share This Form

Powered by eTapestry