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I make a gift

One-time
Monthly
Multiyear
In Memory
Corporate

Does your organization want to pay tribute to a loved one who has passed away? In memoriam donations demonstrates your sympathy, while helping future patients find hope.

Every donation makes a difference to the Hôpital Maisonneuve-Rosemont (HMR) Foundation.

* Required Fields

Field Is Required I would like to make a gift of

$1,000.00

$1000

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$3,000.00

$3000

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$5,000.00

$5000

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$10,000.00

$5000

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OTHER AMOUNT

Enter amount

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Tax receipts for donations over $ 25 will be issued in the cardholder's name only.

Additional Amount:

Field Is Required Please designate this donation to:

Where the need is greatest (Tous solidaires Funds)

Please specify:

Tribute information

Yes, I would like to send an eCard.

Gift in memory of

Recipient email

Select an eCard

Donation Form eCard

eCard Subject

eCard Message

Send eCard onSelect month of credit card Select Expiration Year

Month Day Year

Yes, send me a copy of the eCard.

Your Information

Organization Name

Title

First Name

Middle Name

Last Name

Email

Address 1

Address 2

City

Province

Postal Code (X1X 1X1)

Country

Telephone (XXX XXX-XXXX) only.

I authorize the Foundation to add my organization name on the different donor's walls (if $1 000 or

I authorize the Foundation to add my organization name on the different donor's walls (if $1 000 or more).

Payment Information

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Transaction Fee

Yes, I would like to cover the transaction fee to further support the Hospital by adding 3% to my donation.

Yes, I would like to be opted in to communications from the Hôpital Maisonneuve-Rosemont Foundation (newsletters, events information, foundraising, etc.)

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Privacy Policy

Credit Card Verification Code

The Verification Code is imprinted on credit cards to help merchants verify transactions when the actual card is not present, such as Internet purchases or donations. The merchant uses this number as part of the authorization process with the card issuer.

Please use the images below to locate the verification code for your card type.

A picture of a Visa or Mastercard 3 digit verification code number printed on the back of the card.

Visa & Mastercard

The verification code for Visa or Mastercard is a 3-digit number printed on the back of your card. It appears after the account number or last 4-digits of your account number, in the signature panel.

A picture of a American Express 4 digit verification code printed on the front of the card.

American Express

The American Express verification code is a 4-digit number printed on the front of your card. It appears above and to the right of the embossed account number.