Foundation Donation Form

• Name (required)
• Address
• City
• Province
• Phone Number (required)
• Please list my name as above or:
• Postal Code
• Email Address (required)
• I wish to remain anonymous

I would like to support the Endowment Fund with a donation of:

• $25,000 or more
• $500 to $999
• $10,000 to $24,999
• $250 to $499
• $5,000 to $9,999
• $100 to $249
• $1,000 to $4,999
• $25 to $99

• Other Amount$  

Please note that gifts of $5,000 or more may be paid over a pledge period of up to 5 years.
Please complete the following if you are interested:

• This pledge will be paid at the rate of $  per 
•  year 
•  quarter

Please make my donation in honor of:

• Name (as you wish listed):

Please send an acknowledgement card to:

• Name as above or:
• Address:
• City:
• Province:
• Postal Code:

Please type the numbers you see in the image below.