Health

This form is for our reference in order to provide tax receipts. No amount is collected here when you click submit. E-Transfer donations have to be paid through the appropriate financial services available to you.

Name*

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Email*

Enter Email Confirm Email

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Donation Amount E-Transferred*

Total

$ 0.00 CAD

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Phone

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