Donation:

Please print this form, complete it and enclose it with your donation.

 

Or you may make your donation online using the secure PayPal method by clicking on this button:

Brome MissisquoiYouth Foundation Registration No 869706333RR0001
Yes,
I want to support the work of the Foundation

Enclosed is my donation of

1000$ q      500$ q      100$ q      50$ q      30$ q

Other: $ ____________

A receipt is desired q This gift is to be anonymous q

Name __________________________________

Address _____________________________________

Postal Code ____________  Tel __________________

I would like to make this donation in honour/memory of:

Name ___________________________________

Person to be notified (if any):

Name __________________________________

Address _____________________________________

Postal Code ____________  Tel __________________

I would like information on planned giving q

+     Please return to:     Brome Missisquoi Youth Foundation, Box322, 224 South St., Cowansville, QC, J2K 2X0

This site was prepared by Ken Tannahill