Printable Pledge Form
Peacekeepers Day Do Anything Fete
Name*: _______________________________________________________________________

Street Address*: ________________________________________________________________

City*: _________________________________________________________________________

Province*: ___________________________________ Postal Code*: _______________________

Phone*: _________________________________________

Email address: _____________________________________________________________

 

Contribution amount*: $_______________________

Enclosed CHEQUE MONEY ORDER VISA MASTERCARD AMEX

Credit Card Number: ____________________________________________________________

Name (as it appears on card): _____________________________________________________

Expiry Date: _______________________

Signature: ________________________________________________

CHEQUES SHOULD BE MADE OUT TO:

Canadian Landmine Foundation, 1623 Yonge Street, Toronto, Ontario M4T 2A1.

Tax receipts will be issued for donations of $20 or more. *required fields for tax receipt

GUARANTEE:
100% OF CAMPAIGN DONATIONS WILL BE USED TO FUND MINE ACTION

QUESTIONS?
Phone: 416-365-9461
Fax: 416-365-7019
Email:info@clmf.org

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