Donation Form

If you are filling out this form as an organization, please click HERE.

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Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $0.00 to go to Carleton Place Hospital Foundation and I will donate $0.00.No. I will donate $0.00 and Carleton Place Hospital Foundation will cover the processing costs.

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We take precautions to protect your information: We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment only.

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By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field.

Contact Us
Carleton Place & District Memorial Hospital Foundation
211 Lake Avenue East, Carleton Place, ON K7C 1J4
613-257-GIVE (4483) | [email protected]
www.cpdmhfoundation.ca

Under no circumstances does the CPDMH Foundation sell, barter or lease its donor lists to other organizations. If at any time you wish to be removed from our mailing list, simply contact us at 613-257-GIVE (4483) and we’ll ensure your file is updated within 15 days.

Thank you for your support of the CPDMH Foundation!