Donation Form

MEMORIAL GIVING

In lieu of flowers or a gift, consider a donation in memory of your loved one. Memorial Giving is a thoughtful way to commemorate & celebrate the difference he or she made in your life.

The Foundation is proud to host the Eternal Tree - a memorial located inside the hospital that displays names engraved on a unique tree display.

Your donation will help enhance healthcare by helping us fund state-of-the-art equipment for the Red Deer Regional Hospital Centre. Thank you for your generous support.

Donation Information

Type of Donation

One Time DonationMonthly Donation

Amount

$100.00

$50.00

$30.00

This is a tribute donation

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Type of Tribute

Tribute Name

Additional Information:

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Title

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Contact Information

Title (Mr/Ms)

First Name

Last Name

Company Name

Address

City

Province

Postal Code

Home Phone

Cell Phone

Work Phone

I would like to receive email communication from the Foundation

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

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Billing Address

Same As Above

Address

City

Province

Postal Code

Red Deer Regional Health Foundation

3942 50A Avenue | Red Deer, Alberta, Canada T4N 4E7
Main: 403-343-4773 | Fax: 403-346-2128
[email protected] | www.rdrhfoundation.com

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