In Honour / In Memory Donation


If you would like to make an in honour / in memory donation on behalf of a company use this form.


Thank you for your support of Alzheimer Society Waterloo Wellington. Your Donation will go directly to providing programs and services within Waterloo and Wellington Regions. Thank you for helping us to help others live their best day.

Field Is Required Enter A Gift Amount:
Field Is Required I would like my donation to support:

Tribute Information

Who is this gift in honour of memory of?

Who is this tribute donation from?

Mail a Printed Card

Send an Electronic Card

Please note your personal message cannot exceed 255 characters.

Donor Billing Information

The name and address you enter below must match your credit card details in order to process this donation. The Canada Revenue Agency (CRA) does not permit us to issue tax receipts to anyone other than the donor (the person whose name is on the credit card).

Donor Payment Information

Credit Card Information:

Credit Card Type:
  • American Express
  • MasterCard
  • Visa
What is this?