Shields Memorial Labyrinth Donation Form
Phone: ____________________________________ E-mail:
a Brick: ______________ Commemoration: _____________
a Brick donation or Commemorations: Birthdays, Anniversaries, In
out the form below and include it with your donation form.
Multiple donors should send
separate cheques. Each donor will receive a charitable tax receipt.
Payment options: Cheque or money order in Canadian
or U.S. funds
____ I do not wish to be listed as a donor. (No amounts will be
Make cheques payable to: The Manitoba Labyrinth
Mail to: 70 Fordham Bay, Winnipeg, MB R3T 3B7 Canada
The Manitoba Labyrinth Network is a registered Canadian charitable
organization (#84011 9945 RR0001). Canadian donors will receive
tax deductible receipts for income tax purposes.
Make cheques payable to: The Labyrinth Society
Mail to: P.O. Box 736, Trumansburg, NY 14886 U.S.A.
The Labyrinth Society is a registered 501(c)(3) U.S. non-profit
public charity. U.S. donors will receive charitable contribution
receipts for income tax purposes.
Make sure to indicate:
Carol Shields Memorial Labyrinth
on your donation and include this form with it.