Make A Gift - Queensway Carleton Hospital Foundation

Your gift ensures that our hospital will continue to improve and enhance our outstanding patient care. And during the Canada Post strike, your donation will be matched, dollar for dollar up to $50,000, by loyal donor Betty Shields.

Charitable tax receipts for income tax purposes are issued automatically for donations $10.00 and over. If you prefer to donate offline, please fill out this donation form and drop it off to the QCH Foundation office, or phone us at 613-721-4731.

All fields indicated with an asterisk are required.

What Type of Gift Would You Like to Give?

Gift Type

One-time

Monthly

In Memory

In Honour

Donation Type

Donation Type

Individual

Company

Please Select a Gift Amount

Field Is Required Enter A Gift Amount:

$500.00

$500

$250.00

$250

$100.00

$100

$50.00

$50

$36.00

$36

Other Amount

Enter amount

Yes, automatically repeat this gift every month.

Gift Designation

Field Is Required Gift Designation:

Use my gift where it is needed most.

Direct my gift to:

eCard

eCard

Include eCard

No eCard

Yes, this is a gift in memory or in honour.

Honour Gift Type:

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

Honoree Name:

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

Recipient email addresses:

Yes, send me a copy of the eCard.

Select an eCard:

eCard Subject:

eCard Message:

Donor Information

Donor Title:

Make this gift on behalf of an organization

Organization Name:

Donor First Name:

Donor Middle Name:

Donor Last Name:

Donor Street 1:

Donor Street 2:

Donor City:

Donor Province/State:

Donor Postal/ZIP code:

Donor Country:

Donor Phone Number:

Email Address:

Billing Information

Billing Information is the same as Donor Information

Title:

First Name:

Last Name:

Street 1:

Street 2:

City:

Province / State:

Postal / Zip Code:

Yes, I would like to receive the latest and greatest news and stories from Queensway Carleton Hospital Foundation by email.

Payment Method:

Credit Card

Check Information

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What Type of Gift Would You Like to Give?

Donation Type

Please Select a Gift Amount

Gift Designation

eCard

Donor Information

Billing Information

Payment Method:

Check Information