Donation Form

When you donate to the Red Deer Regional Health Foundation, you are part of a community that strives for world class healthcare in Central Alberta.

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

Note:

Contact Information

Title (Mr/Ms)

First Name

Last Name

Company Name

Address

City

Province

Postal Code

Home Phone

Cell Phone

Work Phone

To help inspire others to donate, I give the Foundation permission to use my name in Donor Recognition related publications and online posts.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

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

Privacy Policy
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.

Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.