Carol
Shields Memorial Labyrinth -
Donation Form [please
print]
Name: ________________________________________________________________
Address: ______________________________________________________________
City: _________________________________________________________________
Prov./State:_____________________________ Code:
_________________________
Phone: _________________________________
E-mail: _______________________
Amount: _____________________
Regular Donation:__________ Buy
a Brick: ____________ Commemoration: ____________
Buy a Brick donation
or Commemorations: Birthdays, Anniversaries, In Memoriam etc.
please fill 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
divulged.)
Canadian Donations:
Make cheques payable to: The Manitoba Labyrinth
Network
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.
U.S.
Donations:
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.
www.carolshieldslabyrinth.ca
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