Pledge Form

DOWNLOAD PLEDGE FORM

Please feel free to complete the following dedication form and consider making a donation.

Name


Surname


Email Address


Contact tel / cell number

Your Loved One's Name

Your Pledge or Tribute

What is 12 + 9? (Security Question to prevent spam)



South Coast Hospice is a non-profit organisation. We are entirely dependent on funds raised, without which we would not exist. 
  
Please make a donation by either scanning on the QR Code below or making a direct EFT payment into the following account:

Bank name: Nedbank 
Branch: Port Shepstone 
Branch code: 139-828 
Account number: 1398 023 256 
Account name: South Coast Hospice Association 
Reference: Tree of Light/Your Name

Once you have made payment, please forward proof thereof via email to fundraising@schospice.co.za