For group or corporate donations, please contact the office at 905-383-9797 ext 101 or donationnotifications@cancerassist.ca.

Gift in Memory

A gift in memory is a distinctive way to commemorate a beloved family member or friend by giving a gift in their name.

In Memory Of*
Donation Amount*
  • $50
  • $100
  • $150
  • $200
  • $250
  • Other $
Please provide the Name and Full Mailing Address of the Family of the Deceased you would like us to send a Notification to:
A Special Message You'd Like to Add:

Your Contact Information

Your full contact information is required to generate a tax receipt. 
The tax receipt will be sent electronically to the email address that you provide.

Country*
Email*
Confirm Email*
Phone*

Additional Information

Send Tax Receipt?
Mailing Preference

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.

Note: After clicking 'Submit' below, you may need to scroll up to enter payment information.

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