Individual Mail-In Donation Form Thank you for your contribution!

FORGET FOR A MOMENT FOUNDATION / LA FONDATION OUBLIE POUR UN INSTANT
Individual Mail-In Donation Form
How to complete this form
Download this Individual Mail-In Donation Form. Fill out the form and mail the completed form and your cheque or money order to
the following address:
FORGET FOR A MOMENT FOUNDATION
1400 WILDBERRY COURT, UNIT 1
OTTAWA, ON K1C 7K6
Your cheque or money order must be made out to: FORGET FOR A MOMENT FOUNDATION. Please do not send cash through the
mail.
Upon request, tax receipts can be issued for donations of less than $25. In order to receive your income tax receipt, be sure to enter
your postal address properly. Please ensure your return address is correct. As per Canada Revenue Agency guidelines, donation tax
receipts must bear the name and the address of the actual donor.
For any questions or comments, please contact [email protected]
SECTION 1 – DONOR INFORMATION
FIRST NAME*
LAST NAME*
M AILING ADDRESS*
CITY*
PROVINCE*
POSTAL CODE*
PHONE NUMBER
EMAIL ADDRESS*
COUNTRY*
PLEASE SIGN ME UP TO RECEIVE YOUR E-NEWSLETTER
☐ NO ☐ YES
SECTION 2 – DONATION INFORMATION
DONATION AMOUNT*
I REQUIRE A TAX RECEIPT
$
☐ NO ☐ YES (AUTOMATICALLY ISSUED FOR DONATIONS OF $25 OR MORE)
(*) required fields
Charitable Registration Number: 820767887RR0001
Thank you for your contribution!
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FORGET FOR A MOMENT FOUNDATION / LA FONDATION OUBLIE POUR UN INSTANT | 1400 Wildberry Court, Unit 1, Ottawa, ON K1C 7K6 | www.forgetfoundation.org
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