Please note this form is intended for the purchase of individual memberships for 2017. Please use a separate form for each person who would like to become a member.
If you would like to buy a membership for any other year or if you are unsure if you are already a member please contact Hospice Halifax at 902-446-0929.
While the cost of membership is not tax deductible, please consider making a donation with your membership which you can claim on your tax return.
Membership for 2017