Donation Form
Please join us in creating enduring memories for all.
Support this important initiative!
Print this form, and mail or drop your donation off at the YMCA
1) Fill in information, 2) Print this page, and 3) Drop off or Mail donation
to:
YMCA of Peterborough, 123 Aylmer Street South, Peterborough, ON K9J
3H8
Name:
Address:
City:
Province: Postal Code:
Telephone: Date:
Email:
Yes, I/We wish to support the YMCA of Peterborough
With a donation of
$2,500
$1,000
$500
$250
$100
Other
This gift is payable over
years (max. 5) beginning M
/ YY
with payments to be made:
annually
semi-annually
quarterly
monthly
My gift is in memory of Doug Raper
Method of Payment
Cheque VISA MasterCard Pre-authorized Payments
Card #
Expiry Date:
/
Signature:
Void cheque attached
Please make cheque payable to YMCA of Peterborough - Capital Campaign.
CRA Charitable Registration #11909 1882 RR0001
I/We would like more information on:
The Campaign
Bequests
Gifts of Securities
I/We wish to remain anonymous
I/We wish not to receive further mailings
