Download Wilson Memorial General Hospital Pledge Form

CEO 4th ANNUAL CHALLENGE
Canada 150 Years...Let us make it a Celebration on June 13th
Adam Brown, CEO & Celebrities from the Community of Marathon will be working with staff in the work place. Tuesday,
June 13th 7:00 a.m. to 8:00 p.m. Each Celebrity will collect pledges and donate 1 hour of their time!
All proceeds to go towards the NEW X-Ray Machine at Wilson Memorial General Hospital
Pledge Form.....My Goal is $500.00 or higher$$$$$
PLEASE PRINT. A tax receipt for a donation of $20 or more will be issued by North of Superior Health Care Group (charitable number 119244705RR0001)
Please include your Box number and legible addresses. Cheques should be made payable to the North Superior Healthcare Group. For more information
please call Charlene at 229-1740, ext 224 or 228-3383
Thank you for your continued Support!
Payment Method
Donation Amount
Name (print please)
Box #
City
Prov. Postal
Phone #
Email
code