If you wish to make a donation, please fill out the form below.
Print and send it to our mailing address at : C.P.
Elysee 89023, Laval, Quebec H7W 5K1
or Tel. (514) 933-8585, Fax (514) 933-1855 or email: email@example.com. All information received is confidential.
Food Cooking Camp Laptop
Postal Code :
Credit Card No.:
Expiration Date :
3 digit code :
'In Memory of' (name):
Message to family :
Family of Deceased:
Event : Theatre Concert 24-hour Row
each = Total
Will pickup tickets :
Special Purpose Donation: $__________ Purpose: __________________
Please complete the appropriate information, then email : firstname.lastname@example.org or fax your ticket request to our confidential fax line at: 514-933-1855 - or call Adrian at 514.933-8585.
I wish to receive an income tax receipt:
Thank you for your generosity.
Our list is confidential. We do not share it with other charitable organizations.