One-time Donation Form - Cedars Cancer Foundation

Together we stand
for cancer patients

Support the fight
against cancer

Cedars Auction and Raffle

Proceeds will benefit the the Supportive and Palliative Care Division at the MUHC

Note: A tax receipt will be issued to the payer for all donations of $18 or more.

Cedars Governors' Circle: By making one or more donations totaling $250 or more within a single calendar year (January 1 to December 31), you will be recognized as a member of a special leadership programme that addresses the needs of cancer patients and their families across the continuum of life, from pediatric, adolescent and adult care to survivorship, palliative and supportive care.

Field Is Required Select Gift Amount:

$100.00

$100

$250.00

$250

$500.00

$500

Other

Enter amount

Thank you contact

The person to thank is different than the contact person above.

First Name:

Last Name:

Title:

Email:

Donor Information

Salutation:

First Name:

Last Name:

Address:

Apt/Suite:

City:

Province/State:

Postal/ZIP code:

Country:

Email Address:

Phone Number:

Email opt in I would like to receive email updates from The Cedars Cancer Foundation.

Additional Amount:

$2.00 Yes, I'd like to offset processing costs so more of my gift can benefit The Cedars Cancer Foundation. $2.00 will be added to my donation total.

Cardholder Information

Please make sure your billing address is exactly as it appears on your credit card statement.

Specifies to use the donor information as the billing information

Salutation:

First Name:

Last Name:

Address:

Apt/Suite:

City:

Province/State:

Postal/ZIP Code:

Country:

Credit Card Information

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Together we stand for cancer patients

Support the fight against cancer

Cedars Auction and Raffle

Donor Information

Cardholder Information

Credit Card Information

Credit Card Information:

Together we stand
for cancer patients

Support the fight
against cancer