Please make a special gift to Heritage Canada The National Trust.

Patron: His Excellency the Right Honourable David Johnston
C.C., C.M.M., C.O.M., C.D., Governor General of Canada
Président d'honneur : Son Excellence le très honorable David Johnston
C.C., C.M.M., C.O.M., C.D., Gouverneur général du Canada
Please make a special gift to Heritage Canada The National Trust.
Yes! I would like to help protect Canada’s heritage landmarks and historic communities across the country
that continue to be threatened or lost through neglect, weak legislation, development pressures and lack of
funding. You may donate by credit card or cheque using the form below. Please return the completed form
by mail or by fax to 613-237-5987. You will receive a tax deductible receipt for the full amount of your
donation.
First Name:
Last Name:
Address:
Address:
City:
Country:
Telephone:
Province:
Postal Code:
Email:
Enclosed is my tax-deductible gift of:
□ $500
□ $250
□ $100
□ $75
or
I prefer to give: $________.
Method of Payment
□ Cheque enclosed payable to Heritage Canada The National Trust
□ MasterCard
□ Visa
Card No.:
Expiry Date:
CCV*:
Name on credit card: __________________________________________
Signature: _________________________________________________
* A three-digit value printed on the signature panel on the back of your credit card., except on American Express
cards where it is a four-digit value printed on the front of your credit card, above and to the right of the card
account number.
HCNT is proud to recognize our donors in the Annual Report, which is distributed to our membership
and posted on our website.
May we acknowledge you by name?
□ Yes
□ No
Thank you for your support!
Heritage Canada The National Trust / Héritage Canada La Fiducie nationale | 190 avenue Bronson Avenue, Ottawa, ON K1R 6H4
[email protected] | Tel./tél.: 613-237-1066; Fax/télé.: 613-237-5987 | www.heritagecanada.org 0614