DONOR INFORMATION |
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E-Mail: |
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Title (Mr., Mrs., Ms, etc.): |
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Name: |
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Corporate Name (optional): |
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Address: |
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Postal Code: |
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Phone Number: |
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Your e-mail is required to receive a confirmation of your donation. |
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CREDIT CARD INFORMATION |
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Credit Card: |
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Credit Card Number: |
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CVV: |
What is this?
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Name on Card: |
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Expiry Date: |
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Donation Amount:
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TRIBUTE GIFTS (In Memoriam and In Honour) |
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Making a donation in the name of a friend or family member is a lasting and meaningful way to let others know you care about the issues of mental health. You may wish to make a donation in memory of a loved one, or in honour of someone on a special occasion or as a note of thanks for a helpful act or a kind word. |
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A Gift Notification card will be sent to the person or family to acknowledge your thoughtful gift. Your charitable tax receipt, accompanied by a letter of thanks, will be mailed to you shortly afterwards. |
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Type of Gift: |
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Name of person this donation is in honour/memory of: |
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Please send a Gift Notification card to: |
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Name: |
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Address: |
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City: |
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Province: |
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Country: |
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Postal Code:
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How would you like to sign the card? (e.g., "The Smith Family") |
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Special message on card (maximum 35 words): |
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NOTE: The amount of your gift will not be mentioned. |
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PLEASE SEND ME INFORMATION ABOUT... |
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Comments / additional information (maximum 50 words): |
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