2015 Hospice Membership & Donation Form
- Help Hospice Help Others!!  I wish to become a member of Pacific Rim Hospice Society. 􀀀 $10
(Receive newsletters, discounts on workshops and vote at AGM)
 I would like to make a charitable donation 􀀀 $50 􀀀 $100 􀀀 $500 􀀀 Other amount $________
Membership & Donation Total Amount: $______ (Amount over $10 receives a Tax Deductible Receipt)
I wish my donation to remain anonymous 􀀀
Name:_________________________________________
Email:___________________________________
Postal Address:________________________________________ Telephone:__________________________
My Donation (over $10) is in Memory of:______________________________ _________________________
Want latest updates or get involved with Hospice!
􀀀 Receive quarterly newsletters by e-mail 􀀀 Receive quarterly newsletters by post
􀀀 Join the Board of Directors
􀀀 Become a Hospice Volunteer
􀀀 Help with events
Please send membership fee and form to P.O. Box 7, Tofino, BC, V0R 2Z0. (250)725-1240.