Donor Information

Please provide the requested information below so that we can process your secure donation.

Email
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Title
First Name
Last Name
Spouse Name
Address
City
Country
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Postal Code
Home Phone Number
Mobile Number

Gift Amount

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Credit Card Information

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Cardholder Name:
Credit Card #:
Security Code (CVV2):
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Expiry:
MM/YY

Gift Designation

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Royal Inland Hospital Foundation
311 Columbia St.
Kamloops, BC, V2C 2T1