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Monthly donation for St.Jerome Regional Hospital
1
Transaction
One-time gift
Monthly gift
Frequency
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Monthly
Commitment start date
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2025/05/15
2025/06/01
2025/06/15
2025/07/01
Monthly donation
$10
$20
$50
Subtotal:
Total:
$
Total:
$
To stop monthly donations please contact our accountant 30 days before the last donation.
2
Personal information
E-mail
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Personal E-mail
Professional E-mail
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Personal
Corporate
Title
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Mr.
Mrs.
Ms.
Mx
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Abbot
Brother
Deacon
Director
Doctor
Father
Honourable
Miss
Monsignor
Mother
Pastor
Professor
Reverend father
Reverend mother
Sister
Gender
First name
Last name
Job title
Company
Country
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Canada
France
Switzerland
United States
Province
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Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Street no.
Street name
Street type
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allée
autoroute
avenue
boulevard
carré
carrefour
cercle
chemin
côte
croissant
impasse
montée
parc
passage
place
promenade
rang
route
rue
terrasse
Apt. / office
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City
Postal code
3
Payment
TOTAL amount
$0
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Forme juridique
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Organization's registration number:
13286 7078 RR0001
Time remaining in your session:
20
Time remaining in your session:
20