Registration Form | Area Coordinators
Registration Form and Area Coordinators

Hello Dear Friend,

    We at PMH bring you greetings and wishes of good health and thank you for your decision to become a Friend of PMH.

    In order to formalise your affiliation with us please highlight and copy the Registration Form below, paste on an e-mail, then complete and send to DAAS Coordinator and to the Hospital Administrator.

REGISTRATION FORM
Name (individual or group):

Where are you located (country)?

You are a friend for how long?

Mailing Address:

E-mail address:

How do you want to contribute?

  • Adopt a ward/unit -
  • Grounds Beautification -
  • Cash Donation -
    (A cash donation to the Princess Margaret Trust Fund is tax deductible.)
  • Fund Raising -
  • Volunteer Programme -
  • Equipment & Supplies Donation -
  • Other Project (Specify) -
Date:

Signature:

Friends of PMH - Area Coordinators

    An Area Coordinator is an individual, group or organisation based in the area from where the donations are solicited and shipped. There are several Dominicans and Dominican Associations who perform that role and who have had the experience in doing it. It is strategic and economical for the success of Friends of PMH to engage and support such existing coordinators.

CANADA
NAME
Hamilton Association
Ontario Association
Sisserou Cultural Club
 AREA
Hamilton, Ontario
Toronto, Ontario
Brampton, Ontario
 E-MAIL ADDRESS
coda_hamilton@hotmail.com
petronella.john@sympatico.ca
bartelink7733@rogers.com

OTHER CARIBBEAN
NAME
 AREA
 E-MAIL ADDRESS

DOMINICA
NAME
The Rotary Club
 AREA
Roseau
 E-MAIL ADDRESS
gstedman@caribiss.com

UNITED KINGDOM
NAME
UK Association
 AREA
Plaistow, London
 E-MAIL ADDRESS
Dominica_UKA@hotmail.com

UNITED STATES
NAME
D.H.A.Inc.
D.A.M.U.S.A.
D.A.R.D.A.
D.A.W.
D.E.O.N.J.
Shirley Allan
 AREA
Houston, TX
Chicago, IL
New York
Metropolitan Area
New Jersey
R.D.F.
 E-MAIL ADDRESS
contact@dominicahoustonassociation.org
damusa1@aol.com
nevlorn@mindspring.com
Gabrielchn@aol.com
daemeraldnj@yahoo.com
shirleyallan@hotmail.com