I Would Like to Donate:

Donation Amount*
  • $25 One-Time Gift
  • $25 Monthly Gift
  • $50 Gift
  • $100 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

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

How did you hear about this fundraising campaign?
  • Billboards
  • Facebook
  • Mailing
  • Website
  • Other

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code