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FOOD

FOR
ACTION
2019
HELP US REACH VULNERABLE CHILDREN
I WILL DONATE: BILLING INFORMATION:

☐☐ $5000 Name: _________________________________________________


☐☐ $2500
☐☐ $1000 Address: _______________________________________________
☐☐ $500
☐☐ $250 City: ___________________________________________________
☐☐ Other: ____________
Province: ____________ Postal Code: ______________________
NOTE:
Tax receipts will be issued for all Telephone: _____________________________________________
cash donations over $20
Email: __________________________________________________

PAYMENT METHOD: PAYMENT INFORMATION:

☐☐ Visa Card Number: __________________________________________


☐☐ Mastercard
☐☐ American Express Expiry: _________________________________________________
☐☐ Cheque
Signature: ______________________________________________