January 2023 | Kelowna General Hospital Foundation

Your Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name of Honoree(s) (Required) and Short Saying (Optional) *

Ex. In Loving Memory of Mr and Mrs. Smith “Always in our Hearts” (Please note: The words must fit in the engravable surface)

Bird Style *

I confirm that a minimum donation of $2,500 has been made *

Additional Information (Connection to a Legacy Gift, Area of Care, etc.)