On-Line Donation

Become a Hero for Zero and help support the work of HIV Edmonton!
 
   DONOR    
  * First Name:  
  Middle Initial:  
  Last Name:  
  * Email:  
  * Address1:  
  Address2:
  * City:  
* Province:
  Postal:  
  Phone:  
  Tribute:  
    denotes mandatory field
 
DONATION    
  Amount: $    
       
  TOTAL: $  
       
   PAYMENT    
  Payment Method:  
  Frequency:  
  Card Holder Name:  
  Card Number:  
  Expiry:  
  CVD:  
       
    Please enter the number you see below:
 
     
       





Privacy Policy

We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.

Contact Us: HIV Edmonton 9702 111 Avenue Edmonton, AB T5G 0B1 PH: 780-488-5742 e-mail: contact@hivedmonton.com Web: www.hivedmonton.com