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Community Warmth Donation Form

Yes! I would like to make a contribution on my City of Medicine Hat Utility bill to the Community Warmth Program. 

DONATION OPTIONS: Please add the monthly contribution amount to my City of Medicine Hat Utility bill:


I acknowledge that checking this box verifies that I agree to the amount above as a donation to the Community Warmth program.

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.