| Please complete and return your cheque or money
order payable to Canadian Geological Foundation |
| Mr. ___ |
Mrs. ___ |
Ms. ___ |
Dr. ___ |
| Surname: |
.................................... |
| Last Name: |
................................................ |
| Address: |
......................................................................... |
| City: |
............................... |
Province: |
......................... |
| Postal Code: |
............................... |
Telephone: |
......................... |
| Amount of Contribution: |
............................... |
Receipt Requested:
|
Yes ___ No ___ |
|
|
Receipt No. |
___________ |
Your tax deductible donation may be sent to:
Canadian Geological Foundation
c/o Hay & Watson Chartered Accountants
1822 West 2nd Avenue
Vancouver, BC, Canada
V6J 1H9
Charitable exemption number: 0346064-230 |
