Electronic Donation Form

Donation will be allocated in accordance with the purpose stated on the form below.

A minimum donation of $20.00 is required to receive a donation receipt. An Official Donation Receipt for Income Tax Purposes will be issued within 7 business days from the donation date. The Official Donation Receipt will be issued electronically or by mail to the addresses provided on this form.

Name of Donor *

First

Last

Mailing Address of Donor *

Address Line 1

Address Line 2

City

OntarioAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvince

Postal Code

Phone Number of Donor *

Email of Donor *

Donation Type: *

• In-kind support
• Monetary Donation

Purpose of Donation *–General Donation

Purpose of Donation *–Construction of the Killean School Bell structurePuslinch Community Centre Digital Sign Replacement

Briefly describe the in-kind support being offered: *

Briefly describe the purpose for the donation: *

Donation Amount *

Minimum donation to receive a donation receipt is $20.00

Minimum Price: $20.00

Total

$0.00

Credit Card *

Card

Name on Card

Submit

Personal information on this form is collected under the authority of the Municipal Act and is maintained in accordance with the Municipal Freedom of Information and Protection and Privacy Act. Questions regarding the collection of this information may be directed to the Township Clerk’s office.

The Township of Puslinch is committed to providing accessible formats and communication supports for people with a disability. If another format would work better for you, please contact the Township Clerk’s office for assistance.