Donation Form

Name:       
Address:       
Address       
Postal Code:       
Phone:       
Fax:       
Email:       

Donation Amount
$10 $25 $50 $100 Other (please specify amount):

Method of Payment
Sending Cheque: Money Order:

Please make cheques/money order payable to Community Living Kawartha Lakes.

Please do not send cash in the mail.

Other Information
Please help us serve you better by answering these questions. Thank you.

Would you like to be contacted with more information about Community Living Kawartha Lakes? If yes, please indicate the type of information of interest to you (check as many as apply). If no, please skip this question. Thank you.
Donating to Community Living Kawartha Lakes
Volunteering with Community Living Kawartha Lakes
Employment with Community Living Kawartha Lakes
Our services
Joining our committees or the Board of Directors
Providing a community job or volunteer placement for the people we support
Other (please specify):

Would you like to receive an email notice when our website is updated?
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If you chose 'yes', Please include your email address:

Would you like the option to make online (credit card) donations to Community Living Kawartha Lakes?
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Would you or anyone in your family use a discussion board for siblings of individuals with intellectual challenges if it were available through Community Living Kawartha Lakes?
Yes No

Other Comments:

     

(Registered charitable number 107627366 RR0001)

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