Pathway of Angels Form

The Pathway of Angels surrounds the Deep River and District Hospital Helipad and is built with personalized engraved stones in memory of, on behalf of, or in honour of a loved one, individual or family.

Part of the proceeds from the sale of the stones supports the Deep River and District Hospital Foundation. If you wish to purchase a stone please complete the form below.

If you have any questions or would like to request additional information please call 613-584-1266 ext.131.

First Name Last Name

Address

Telephone Number - -

Name on the Stone

Wording on the stone

Desired logo/Emblem
Please pick one of the following Emblems to be placed on your stone:

Please Note:

cheque for $150.00 should be mailed directly to the hospital attention: Sue Lachance.

- until the cheque is received, no order will be placed.