I Would Like to Donate:

Donation Amount*
  • $1,000 Gift
  • $500 Gift
  • $250 Gift
  • $100 Gift
  • $25 Monthly Gift
  • Other $

If you are making a donation in tribute to someone, Hospice Halifax would be happy to send them a card notifying them or a family member of your donation.

 

Please select the type of tribute applicable for the donation, the name of the tributee and the full name and address of the person to whom a notification card should be addressed.

Tribute Name
Send notification card to
Card Address

Donor Information

Company*
Job Title
Country*
Email*
Confirm Email*
Phone*

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
Powered by eTapestry