CMHA Niagara


Notify Family?

If you would like CMHA Niagara to notify the family of your gift made in memory of their loved one, please provide a name and address for us to forward to in the Additonal Comments box at bottom of this form.

(Note- we will not disclose the amount of your gift)


Gift Information

In Memory Of
Donation Amount*

Contact Information

Confirm Email*
Donor names may be published in official publications of CMHA Niagara, such as our Annual Report and website. Do you consent to CMHA Niagara publishing your name in these publications?*
  • Yes
  • No


Please let us know how we can keep in touch with you.

Payment Information

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.
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