Donation Form

You have now entered a secure site. Please provide us with your contact and payment information.

The donor contact information is required to generate a tax receipt.
Tax receipts are issued by our Provincial office for donations $25 and over.



Donor Contact Information

First Name (*)
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Last Name (*)
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Address (*)
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City/Town (*)
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Province/State (*)
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Postal Code/ZIP (*)
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Country (*)
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Phone Number (*)
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Donor Email Address (*)
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Donation

How would you like to donate (*)

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Donation Amount (*)
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What type of gift would you like to give? (*)
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Donation For: (*)
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Payment Information

Credit Card Type (*)
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Credit Card Number (*)
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Card Holder's Name (*)
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Credit Card Expiration Month (*)
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Credit Card Expiration Year (*)
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CVV Number (*)
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(3 digits located on back of card)
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