Online Donation Form

Enter the dollar value you wish to donate.*

Yes, I want to help support and strengthen health care in my community. Your donation is a tax-creditable gift to EKFH for the benefit of those who need care and support.

Gift frequency*

This is a one time gift
This is a monthly gift

Choose if this is a one-time gift, or a monthly gift.

Please designate my/our gift to

Which Department?

Tribute / Next of Kin

This is a tribute gift in memory or honour of:
Next of Kin to be Notified:

in Memory or Honour of:

Next of Kin Name

First Last

Next of Kin Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Next of Kin Phone

Comments

Do you have any comments for EKFH?

Please send my charitable tax receipt to:

Name*

First Last

Please send my charitable tax receipt to:

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Privacy Agreement

I agree that my name and/or photo can be recognized as part of EKFH's donor recognition programs.

Consent to Contact

Canadian Anti-spam Legislation - your consent is required. I give my consent to be contacted by EKFH to be kept up to date on events and fundraising activities supporting health care in the East Kootenay.

Total Donation Amount

$ 0.00 CAD

NOTE: Once you have submitted you will be brought to a confirmation page. Please be patient as this page loads and do not re-submit this form.

A confirmation email will be sent to the email address you entered above once your transaction has been processed.

Phone

This field is for validation purposes and should be left unchanged.

Please send my charitable tax receipt to:

NOTE: Once you have submitted you will be brought to a confirmation page. Please be patient as this page loads and do not re-submit this form.

A confirmation email will be sent to the email address you entered above once your transaction has been processed.

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Legal

	13 24th Ave N, Cranbrook, BC, V1C 3H9, Canada
	250-489-6481
	1-877-489-6481Toll Free
	[email protected]

Please send my charitable tax receipt to:

NOTE: Once you have submitted you will be brought to a confirmation page. Please be patient as this page loads and do not re-submit this form. A confirmation email will be sent to the email address you entered above once your transaction has been processed.

NOTE: Once you have submitted you will be brought to a confirmation page. Please be patient as this page loads and do not re-submit this form.

A confirmation email will be sent to the email address you entered above once your transaction has been processed.