Donate Now – Medical Imaging Campaign (PAH Staff Only)

Step 1: Donation Amount and Contact Information

- How much would you like to donate? (Please enter dollar amount only, no cents. Eg. 500 for $500.00 or 150 for $150.00)*
We require the following information in order to issue your official receipt for income tax purposes. (For CRA compliance, you are required to provide your full name and home address. Fields marked with an asterisk are mandatory). Business name and address are required if making a corporate donation. To make a donation, simply complete the form below before proceeding to our secure payment portal on GiftTool.
- Title*
- First Name*
- Last Name*
- Email*
- Phone*
- Street Address*
- Business Name
- City*
- Province*
- Postal Code*