Donation Pledge Form - Cancercare Manitoba Foundation

DONATION

PLEDGE FORM

USE THIS FORM TO RECORD

DONOR INFORMATION

AND SUBMIT WITH PROCEEDS.

Event Name: ........................................................................................................ Event Date: ................................................................

PLEASE MAKE ALL CHEQUES PAYABLE TO:

CancerCare Manitoba Foundation

Contact Name: ..................................................................................................... Telephone No.: ..........................................................

FIRST & LAST NAME (PLEASE PRINT)

MAILING ADDRESS

CITY

POSTAL CODE

TELEPHONE /EMAIL

DONATION

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E:

T:

E:

T:

E:

T:

E:

T:

E:

T:

E:

T:

E:

T:

E:

T:

E:

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T:

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T:

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THANK YOU FOR YOUR SUPPORT!

Tax receipts will be sent electronically for donations

TOTAL CASH DONATIONS:

of $15 or more providing all fields are completed.

Please print carefully.

TOTAL CHEQUE DONATIONS:

PRIVACY POLICY: CANCERCARE MANITOBA FOUNDATION GUARANTEES THAT WE DO NOT UNDER ANY

CIRCUMSTANCES SELL, TRADE OR RELEASE THE FOUNDATION MAILING LIST. YOUR NAME CAN BE REMOVED

For credit card donations please call 204-784-2777

FROM THE MAILING LIST BY WRITING OR ATTENDING THE CANCERCARE MANITOBA FOUNDATION OFFICE.

GRAND TOTAL:

or donate online at

Registration No. 886886746 RR0001