Fondation du Centre hospitalier de l'Université de Montréal

Donation information

One Time Donation

I wisk to make a donation of:

Monthly donation

I wish to start my monthly donation on (date):

I wisk to make a monthly donation of:

An official donation receipt will be issued for donations of $20 or more.

We are committed to protecting your privacy and safeguarding any information you provide us.

Personal information

Confirm email

Title

First name

Last name

Country

I would like my donation to be registered under a different name.

Yes

I would prefer my donation to remain anonymous.

Yes

I agree to create my account according to the terms of use.

Why create an account?

Please note that by creating an account, you accept the conditions of use and privacy policy.

Payment

TOTAL amount

$100.00

Tell us what inspires you to donate (optional and anonymous)

Notes

Cheque

Credit card

Direct debit from bank account

I would like to know more about the impact of my donation, please sign me up for the newsletter.

Fondation du Centre hospitalier de l'Université de Montréal (CHUM)
800-465 McGill St.
Montreal, QC H2Y 2H1
Tel: 514-890-8077, ext. 35205 or
1-866-DON-CHUM
Fax: 514-412-7422

THANK YOU FOR YOUR GENEROSITY!

Charitable Registration Number:

88342 9961 RR0001

Time remaining in your session: 15