Online Donations Form

Fields marked with a * are mandatory.

Step 1: Donation

Donation frequency Single
Monthly
*Donation amount: $10 $25 $50 $100 $150 $250
Other $
*Amount per month: $10 $25 $50 $100 $150 $250
Other $

Thank you for joining the HUGS for KIDS monthly giving program. You will receive an electronic receipt for your initial donation. Future monthly donations will be charged to your credit card on the 15th day of each month. A cumulative tax receipt will be mailed to you at year end.

I would like to make my donation in recognition / honour of someone.

Please designate my gift to Extending Our Reach initiatives, which includes our Abbotsford hospice building and provision of services.

Step 2: Payment Method

Card Type:
*Expiry date:
*Card Number:
*Cardholder Name:
*CVV: What's this?
*Enter the word below:

If you can't read the word, click here

Step 3: Personal Information


(as printed on Tax Receipt)
Title:
*First Name:
*Last Name:
*Address:
Suite/Apt. #:
*City:
*Province/State:
*Postal/Zip:
*Country:
*Phone: (with area code)
*E-mail:
This donation is in the name of a company or group
    Company/Group Name:

Step 4: How did you hear about Canuck Place Children's Hospice?

Received information in mail
Website
Radio
TV
Newspaper
Friend / Family
Donated previously
Participated in a Canuck Place event

Step 5: Comments (your feedback to Canuck Place)

Step 6: In Honour / Memory Of (optional)

In Honour Of In Memory Of
Tribute Name:
(name of whom
you are recognizing)

Mail a note card (Canuck Place will notify the recipient in a general manner)
Send E-cards (your personalized message to recipient) - see how it works >
Do not send a card / notification of Tribute donation
Mail to:
Recipient Name:
(who to notify of Tribute)
Address:
Suite/Apt. #:
City:
Province/State:
Postal/Zip:
Country:
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Canuck Place Children’s Hospice recognizes its obligation to respect and protect the privacy of our donors and website visitors. Click here for Privacy Policy.