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1. Tax Receipt Information

Gift Information

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I would like to make

Please make this in Canadian Dollars US Dollars

3. Financial Institution or Credit Card Information

Please fill in Section A to use your credit card, or Section B to use automatic bank account withdrawal.

A. Credit Card Information
Card Type:
Name as on Card: 
Card Number:
Expiry Date:  
B. Financial Institution Accounts
Canadian Account: Financial Institution:  
  Transit/Branch Number:  
  Institution Number:
 Account Number:
United States Account: Financial Institution:
  Routing Number:

  Account Number:

4. We are listening

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Thank you for investing in our mission. We greatly appreciate your support!