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Printable Donation Form

Enclosed is my/our donation of $__________.
(Tax receipts and/or cards are mailed for gifts of $10.00 or more.)

___ Cheque payable to Variety the Children's Charity of Manitoba

OR

___ Charge my: Visa _____ MasterCard _____ American Express _____

Account #_________________________________________

Expiry Date____________

Name _______________________________________________________________

Address _______________________________________________________________

City _____________________________________

Postal Code ___________________ Telephone Number _________________________

If card is to be mailed please complete the following:

Card to be signed from:

_____________________________________________________


This gift is given in memory of:

_____________________________________________________


This gift is given in honour of:

_____________________________________________________

Please send acknowledgement to:

Name __________________________________________________________________

Address _______________________________________________________________

City ______________________________________

Postal Code ___________________

Please mail donations to Variety the Children's Charity, #2 - 1313 Border Street Winnipeg, Manitoba R3H 0X4

Donations may also be made by telephone using the above credit cards. Please call 204.982.1050

#2 - 1313 Border Street | Winnipeg, Manitoba R3H 0X4 | Phone 204.982.1050 | Fax 204.475.3198
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