DONOR FORM

HELP OUR STUDENTS PROGRAM - DONOR FORM

Donor name / Organization: ___________________________________________________________

Donor address: __________________________________________________________________

                             __________________________________________________________________

Contact person (if different from Donor): ______________________________________________

Telephone: ___________________  Email address: ________________________________ 

Amount of donation: $ ______________ Please make cheque payable to HOST PROGRAM

I wish to direct this donation as follows:

[     ]  to be used for students from any school as most needed;

[     ]  to be used for students of _______________________________________________________

Note: a minimum donation of $500 is required to make a directed donation. Once directed donations for a specific school reach $1,100, an additional award will be set up. If there remains less than $500 in the school’s directed reserve at the end of the school year, the funds will be used to pay for the current year’s awards for that school.

I wish to make this donation:

[     ]  in memory of: ______________________________________________________________

[     ]  in honour of: _______________________________________________________________

We can send a donation card  to announce your donation.

Mail donation card to:  ___________________________________________________________

                                        ___________________________________________________________

or send to this email address:  ___________________________________________________


Please send the completed Donor Form, along with your donation cheque, to:

Help Our Students Program

59 Callaway Court

Ottawa, ON  K1C 7S4


Official Registration # 81447 4730 RR0001     Canada Revenue Agency: www.cra.gc.ca/charities



hostprogram@rogers.com    © RICHARD LUSSIER 2016