Make a gift in memory - Peterborough Regional Health Centre Foundation

Gift & Payment Information

Make a donation in memory of a loved one today.

Giving in memory of a friend or loved one is a meaningful way to express your support during a difficult time.

Simply complete the donation form and provide the name of the person you wish to honour.

If you wish, you can choose an e-card to send to their loved ones, and add your personalized message to let them know you are thinking about them. Or to have a printed card sent by mail, please complete the Next of Kin's information below.

Field Is Required Design your gift:

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Field Is Required Gift Designation:

Use my gift where it is needed most.

Direct my gift to:

My gift is in memory of:

Title:

First Name:

Last Name:

Memorial or Tribute Card type

No Card

eCard

Paper Card

Yes, Send an eCard Yes, I would like to send an eCard.

Send eCard on:Select month of credit card Select Expiration Year

Recipient email address(es):

Select an eCard:

Copy of Basic Stationery_2021 for Memorial ECard Purple Flower v2

Copy of Basic Stationery_2021 for Memorial ECard White Flower

eCard Subject:

eCard Message:

Yes, send me a copy of the eCard.

To have a printed card sent by mail, please complete the Next of Kin's information below

Next of Kin's Name:

Street:

City:

Province:

Postal Code:

Your Contact Information (Donor)

Organization gift

Yes, this is a gift from an organization

Organization:

If you are giving on behalf of a business or group, please ensure your information matches the name and address associated with the credit card account to avoid anti-fraud declines.