Donation Form

Please fill out the following information so that we may process your donation. Submitting this form will take you to PayPal to complete your payment. If you prefer to use VISA or MasterCard to make your donation, please call our offices at (519) 836-1697, and we will be pleased to take your information over the phone. Thank you.

How did you hear about the DSC?:

Full Name (for tax receipt): *

Donation Type: *

Address (for tax receipt): *

Please provide your street address.

Postal Code: *

Please enter your postal code in the format N1H 6J3

Telephone number: *

Please provide your telephone number in the format 519-836-1697

Email: *

We need your email address in order to send you confirmation of your support. The DSC does not and will not ever sell or rent your information.

Is the sponsorship for you or is it a gift?:

If the sponsorship is a gift, please provide the recipient's name and address, including postal code.

Gift Recipient's Address:

Please enter the gift recipient's address, including postal code.

Would you like us to send the sponsorship pack to you, or directly to the recipient?:

We are happy to send the gift directly, if you like.

In 12 months, would you like a renewal request to be sent to you, or to the recipient of the gift?:

Would you like a personal message to be sent with the gift?:

If you would like us to include a personal message with your gift of sponsorship, please provide it here.

Is this an 'In Memory' donation or sponsorship?:

Name of person in whose memory/honour you'd like to make this donation or sponsorship:

Would you like us to send an acknowledgment card of thanks to the person or the estate of the person you are honouring?:

If yes, please provide the name and complete address of the person or estate to whom we may send acknowledgment. Thank you.