Fillable Event Donation Form printable pdf download

Event Donation Form

Thank you! Your donation is important to us. Please consider donating online instead of on this event donation form. Online

donations help us reduce administration costs and you receive an immediate tax receipt – donate online at

cancer.ca/supportCCS

I AM FUNDRAISING FOR:

Cops for Cancer

Daffodil Dash

Relay for Life

Slopes for Hope

Other :

I have organized my own event to support the Canadian Cancer Society, called :

EVENT PARTICIPANT INFORMATION: Please complete participant name on each donation form

RETURNING DONATION FORMS & MONEY:

Participant Name

All funds raised must accompany the donation form(s)

Do not hand in money without donation form(s)

Phone #

Event Location

Donation form(s) must balance to funds received

Team Name (if applicable)

DONATION INFORMATION: Donor’s name and address MUST be complete and legible to receive a tax receipt.

DONATION

Required fields are marked with an *

AMOUNT:

First Name*

Last Name*

Mrs

Miss

Mailing Address*

City*

Province*

Cash

Cheque

Postal Code*

Phone #

Under $25 Receipt

I am interested in becoming a monthly donor to the Canadian Cancer Society

Requested

First Name*

Last Name*

Mrs

Miss

Mailing Address*

City*

Province*

Cash

Cheque

Postal Code*

Phone #

Under $25

I am interested in becoming a monthly donor to the Canadian Cancer Society

Receipt Requested

Mrs

Miss

First Name*

Last Name*

Mailing Address*

City*

Province*

Cash

Cheque

Postal Code*

Phone #

Under $25

I am interested in becoming a monthly donor to the Canadian Cancer Society

Receipt Requested

First Name*

Last Name*

Mrs

Miss

Mailing Address*

City*

Province*

Cash

Cheque

Postal Code*

Phone #

Under $25

I am interested in becoming a monthly donor to the Canadian Cancer Society

Receipt Requested

TAX RECEIPT INFORMATION:

TOTAL LINES 1-4

• Help us keep our mailing costs down and put more donations to work in the fight against cancer.

Only donations of $25 will be automatically mailed a receipt

• Donor’s name and address must be complete and legible to receive a tax receipt

ADDITIONAL FUNDS

• Charitable #11882 9803 RR0001 (Canada); 98-6001242 (USA)

(anonymous, do not include Gaming)

• Please make cheques payable to Canadian Cancer Society

PLEASE SPECIFY

PRIVACY: The Canadian Cancer Society (CCS) is committed to protecting your privacy and your personal

information and complies with the Personal Information and Protection Act (PIPA). The information you provide

will be used to issue a tax receipt and additionally may be used to keep you informed of CCS activities including

programs, services, special events, funding needs, opportunities to volunteer or to give and for ensuring accurate

SHEET TOTAL

recognition of donors and their families. If at any time you wish to be removed from any of these contacts,

please let us know by calling Donor Services at 1-888-700-1131 or emailing donorservices@bc.cancer.ca.

FOR CANADIAN CANCER SOCIETY USE

BOX 1

BOX 2 – MANDATORY

Cash Amount Total

Verified

Code: 40001 275

rev code

dept

office

activity

designation

Cheque Amount Total

Verified

Date Deposited:

Total Donations Collected

Verified

Depositor’s Name (Please print first & last name)

)

CCS Person (Verified By:

Information entered into Luminate

Initial

Deposit “Slip” #:

Created NOV 2016

430305

Event Donation Form

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