DONATION

YES! I WISH TO CONTRIBUTE AS FOLLOWS (check one):
Annual Membership: $20 individual, $30 family. Friend (up to $75). Donor ($76-$250); Supporter ($251-$750); Patron ($751-$2000); Benefactor ($2001-$6000); Sponsor (over $6000).

Please fill out this form so we may contact you about remitting your contribution.
Donations are tax deductible, and you will be issued a receipt.

Name:

Address:

City or Municipality & Province:
Postal Code:

Phone: E-mail:

Please indicate your name as you wish it to appear in our annual report and on performance programs:

or check here if you do not wish to be listed

Additional Information or Special Requirements:

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