Yes! I would like to support Indigenous Achievement! Single Gift Amount $25 $50 $100 $250 $500 My Choice $ Corporate Matching Gift Program: If you are an employee, director or retiree of a matching gift company, you can double or in some cases triple the size and impact of your gift to Indspire. Inquire with your employer to find out if your company will match your gift to Indspire. ________________________________________________________________________________________________________________________________________ Please select a payment option Cheque (Payable to Indspire) VISA MasterCard American Express Cardholders Name Card number Expiry date Cardholder’s signature Today’s date / You can also make a secure donation online at: www.indspire.ca ________________________________________________________________________________________________________________________________________ Your contact information (required for tax receipt purposes) Mr. Mrs. First Name Last Name Ms. Miss Other Mailing Address City Province Postal Code Email Home Phone ( ) - Mobile Phone ( ) - Work Phone ( ) - Please list my name in recognition materials as Please list my name in recognition materials as ‘Anonymous’ ________________________________________________________________________________________________________________________________________ Other ways to help: I have named Indspire as a beneficiary in my will. Please send me information on leaving Indspire a gift in my will. Please return completed form to: Indspire 555 Richmond Street West, Suite 1002 Toronto, Ontario M5V 3B1 Or you can submit by Phone 416.987.0261 Fax 416.977.1764 Email donate@indspire.ca Charitable registration number BBN 118834696RR0001 Indspire respects your privacy. The information on this form is collected and used for the administration of the organization’s fundraising and communications activities. At all times it will be protected in accordance with the Personal Information Protection and Electronic Documents Act. To help minimize cost, Indspire exchanges lists with other charitable organizations from time to time. You can opt out of this anytime by calling 855 INDSPIRE ext 261 or via email at donate@indspire.ca or via mail at: 1002 – 555 Richmond Street West, Toronto, Ontario M5V 3B1.
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