In Memory Fundraiser Application Form

Thank you for your interest in supporting Richmond Hospital Foundation by creating a memorial page for your loved one. Please provide the information required below. We will create your tribute page for you and email you a link to review before it goes live.

In Memory Form

Thank you for your interest in supporting Richmond Hospital Foundation by creating a memorial page for your loved one. Please provide the information required below. We will create your tribute page for you and email you a link to review before it goes live.

Name of the person you are remembering:

Name *(Required)
Please add the content you would like to appear on the memorial page. Many people will share a favourite memory or story about their loved one, or will include information from the obituary.
(if you would like your funds designated to an area not listed, choose "other" from the dropdown and type in the name below)
Photo Upload
Accepted file types: jpg, jpeg, png, gif.
Please include a photo of your loved one that can be displayed on the memorial page. Preferred image size is 300px x 300px.

Contact Information

Please let us know who we should contact in regards to this memorial page.
Name *(Required)