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hospital family
Donation form - Annual fundraising campaign
Please download and complete the following form and return it to the HRE Foundation either by email or in person.

Employee Lottery

Application form

I authorize the Edmundston Regional Hospital to deduct the amount of $ 5 from each of my paycheques and to remit this amount to the HRE Foundation as part of the fundraising activity "Edmundston Regional Hospital Employees Lottery".


I acknowledge that a minimum of 400 employees is required for the lottery. I also acknowledge that I may stop participating in the lottery by giving 30 days written notice to the Foundation. The details and lottery withdrawal form are available at the Foundation office.


In the event that I win a lottery prize, I consent to my photo being taken and published in the Foundation's information and promotional documents.

Thank you for submitting!

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