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Membership Form

Please enter my membership in Bermuda Cancer and Health Centre, fees will go towards our goal of raising $750,000 to upgrade diagnostic equipment and patient support systems; thereby increasing early cancer detection and decreasing the time between screening and diagnosis.

Upon completion of this form you will be taken to the payment page.

All fields marked with a star are mandatory

Membership Form

This should be the name on the Credit Card with which you are using to donate - if that is different to your name, you can override this value by checking the override box above.

Mailing Address