Donate

Please complete the form and either click the 'send' button or print the form and post
(with a cheque made payable to 'The Cancer Society, Canterbury/ West Coast Division'):

Address:

Cancer Society (NZ)
PO Box 13 450
Christchurch
New Zealand

Telephone: 03 379 5835

Name / Company Name * :
Postal / Delivery Address * :
Email * :
Telephone :
Contact Name :
 
First NameLast Name
Is this donation in memory of someone?
 Persons Name:
Notify the family?

Address of family to notify :


* indicates required fields

Enter a dollar value into the first field then select your payment type to be taken through to our secure payment process.

$
Total $