L'association des jeunes de la rue

  1. I would like to donate to your cause.

  2. Please circle the amount you wish to donate:

    $10.00   $20.00   $50.00   $100.00   $1000.00   Other: $________________

  3. In order to receive your tax receipt, please print your name and full address.
    NOTE: A tax receipt will not be issued for donations under $10.00

    Name: __________________________________________________________________

    Address: _______________________________________________________________

    City: _____________________ Province: ___________ Postal Code: _________

  4. Please send this completed form and a check or money order for the above amount, payable to:

L'Association des jeunes de la rue
307 Cedar Street
Sudbury (Ontario)
P3B 1M8

For more information, contact Lise Sénécal at (705) 675-6422.