Make your own free website on Tripod.com

Donation form

INTERNATIONAL
Our Service Programs
Communication & Information
Atmospheric & Environmental Support
Employment Counseling
Breaking the Cycle of Poverty
Breaking The Cycle Of Violence
Settlement Services
Homeless Support Initiative
AIDS Prevention
Drug Abuse Prevention
Healthcare/Mental Health Assesment (Support Initiative)
Legal Matters
Advocacy
Economic Development & Commercial Research
Arts and Culture
Sports & Recreations
Getting Involved
Members Page

DONATION AMOUNT

I would like to donate the following amount: (please circle)

25 50 100 200 500 1000

Other amount: ________________________________

* Donations made are tax deductible for Canadian

Tax Payers for the amount of $50 CAD or more.

If you are eligible and require a receipt, please circle

one of the following:

Yes, I require a tax receipt

No, I do not require a tax receipt

Currency (please circle)

CAD USD EURO GBP AU NZ

PAYMENT DETAILS

Please indicate how you wish to pay: By Credit Card:

VISA or MasterCard (please circle)

Card #________________________________

Expiration Date _____/_____ (yr/mo)

Cardholder Name_______________________

Signature______________________________

* Charges to your credit card will be based on

the CAD$ exchange rate at the time of your

donation.

Cheque or Money Order (please circle)

* Please note that cheques and money orders can only

be accepted for CAD or USD

* Cheques and money orders should be made out to

the Planeterra Foundation

DONOR INFORMATION Note: If applicable, Charitable Tax Receipts will be issued to

this address

Name: Address:

City: Province or State:

Country: Postal or Zip Code: Tel #:

Email:

By sponsoring the Planeterra Jump for Charity, you will be helping to support community projects in

Latin America that focus on the areas of health, education, childcare, community development and

environmental conservation. For more information about Planeterra, visit www.planeterra.org

Jump For Charity

Donation Form

Please send this form along with your donation to:

Planeterra Foundation

355 Eglinton Ave East, Toronto, ON, M4P 1M5, Canada

Or if paying by credt card you can fax it to:

(416) 260-1888

Enter content here

Enter supporting content here