Donation Form





Name: (required)
Email: (required)
Phone:
Address: (required)
City: (required)
Province: (required)
Postal Code: (required)
Place of Work: (optional)
Does your company offer
Match my Gifts?:YesNo

Please designate my/our gift(s):

Where the Need is Greatest

Educational Programs (any and all ages)

Children's and Youth Programs

Senior's Programs

McDougall Street Reunion

Building Trust Fund

Other Special Events
Please Specify Event:

Other,
Please Specify:

My/Our Payment Schedule

A single payment gift of

A total pledged commitment of in payments of:

anually for:

monthly for:

Beginning date for the pledge payments:

Please contact me

My/Our Payment Method

Cheque (Please make cheque payable to the Diocese of Huron.)

Direct Debit from my/our bank account ( Processed: )

Credit Card ( Processed: )

Designation and Recognition (indicate as many as are appropriate)

My/our name as it should appear on donor listings

My/our giving is in Memory

My/our giving is in Honour

Occasion:

I/we intend to make an estate or planned gift to the Northstar Cultural Community Centre.

I/we have finalized the paperwork and a copy is attached for your files.

Please send us additional information to share with our lawyer, insurance representative and/or other.

I/we would like you to call us so that we can discuss the opportunities for making a planned gift.

I/we wish our giving to remain anonymous

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