Donation Form 1

You are now on the Otago Community Hospice donation page - please follow the prompts to make a donation to help keep specialist palliative care free for all those who need it in Otago.

Back to Otago Hospice Website

Persons name *

Title

First name

Last name

Email address *

Phone Number *

Address

Address line 1

Address line 2

Address line 3

Address line 4

Town/Suburb

City

Postcode/Zip

Is this donation in memoriam?

Name of person in memory of

Giving Number

If you are a prior Hospice donor, you will have a donor number. If you know this number, please input here: If you are a new donor, disregard this box

Amount in NZ$ *

Donate method *

Once you hit submit you will be transferred to our secure payment system to complete your donation

Secure Payment Site

Comments

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