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Bucket of Bucks - E-Transfer Pre-payments
Instructions:
Please fill out and submit the form below prior to sending E-Transfer.
Pre-payments will not be processed until
both
the submission form
and
E-Transfer are received.
After Submitting form, send E-Transfer to: Info@HospiceMiramichi.com
*
Indicates required field
E-Transfer Sender
*
Sometimes E-Transfer accounts are under different names. Please let us know who the transfer will be received from to help ensure we match up the submission form with the correct E-Transfer.
Ticket Holder Name
*
First
Last
Bucket of Bucks Number
*
Phone Number
*
Email
*
Select One (Pre-Payment Amount)
*
5 Weeks ($10)
6 Months ($52)
1 Year ($104)
Comment
*
Submit
Home
About
Services
Day Hospice
Community Outreach
Grief & Bereavement Groups
Residential Hospice
The Hospice Shoppe
Shoppe Volunteer Spotlight
Fundraising
Random Stuff for Sale
Butterfly Release
Home for the Holidays
Angels Remembered
He Shed Credit Card
Volunteer
Donate
Contact
Careers