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Donation
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Mandatory fields
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First Name
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Last Name
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Phone
Format: 416-555-5555
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Phone Type
Mobile
Home/Landline
Choose whether contact number is a mobile or landline.
Street Address
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City
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Province
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Outside Canada
Postal Code/Zip
Preferred format (X1X 1X1).
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Email
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Card Sent
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Sent
Not Required
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Amount ($CAD)
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Payment frequency
One-time
Monthly
Donation Purpose, if Other
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Donation Purpose
2019 Gift Agreement
Women's Auxiliary General Needs Fund
Bravery Beads
PlayPark Toys and Supplies
Other
In Memory or in honour of:
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Is this donation in memory or in honour of someone?
No
Yes, in honour of
Yes, in memory of
If this donation is in memory or in honour of someone, enter the name in the corresponding field below.
In memory of name
Please type in the name of the deceased
In honour of name
Please fill in the name of the person being honoured
Recipient of Note of Acknowledgment
*
Do you wish to send a note of this honour/memorial donation to someone?
No
Yes, by email
Yes, by mail
If you choose Yes, enter the email or mailing address in the corresponding field below.
Recipient's email address
Recipient's mailing address
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Personal Message
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Personal Message to be sent to the Recipient
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If you would like us to share your contact information with the recipient, please authorize
No
Yes
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