Printable Form
 

To support the work of the Canadian Landmine Foundation you can count on me for a tax-deductible gift of:

$10 $20 $40 Other $ ___________
 

Name: _______________________________________________________________________

Street Address: ________________________________________________________________

City: _________________________________________________________________

Province: ___________________________________ Postal Code: _______________________

Email address: ________________________________________________________________

In Memory of:: _______________________________________________________________

In Honour of:: _______________________________________________________________

Enclosed please find a cheque or bill to my VISA MASTERCARD AMEX

Credit Card Number: ____________________________________________________________

Expiry Date: _______________________

Name (as it appears on card): _____________________________________________________

Signature: ________________________________________________


Monthly Donations:

OPTION #1: I'd like to make a monthly gift from my chequing account. I've enclosed a sample cheque marked "void", to give you the information necessary to make the automatic withdrawals.
I prefer to give my gift on the __________ of the month.

OPTION #2: I prefer to make a monthly gift through my
VISA MASTERCARD AMEX (please complete credit card information above).

You may change or cancel your monthly donation at any time
by calling us at 416-365-9461.

Canadian Landmine Foundation, 1623 Yonge Street, Toronto, Ontario M4T 2A1. Email:info@clmf.org

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