RESIDENCE INVOICE PAYMENT
 

MEMBERSHIP FORM

 
 
* Name: *Date (mm-dd-yyyy):
*Mailing Address:

*Postal Code:

*Phone Number:

*Email:

 
I would like to pay my $10 annual membership fee by Visa/MasterCard through secure online form. Once membership information Is complete and form is submitted you will proceed to secure payment form.
(Regretfully, tax receipts cannot be issued for membership fees)
By making application to be a Delta Hospice Society member, I support the Constitution and Bylaws of the Society

Thank you for supporting the Delta Hospice Society!
 
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