Donation by Mail or Fax
Help make a difference in the lives of people worldwide with your tax-deductible gift to CNANW.
Print this form and send with a cheque or credit card information to: CNANW
c/o Project Ploughshares
140 Westmount Road North,
Waterloo, Ontario, Canada. N2L 3G6
email: firstname.lastname@example.org * Denotes Required Information
Yes, I would like to become a CNANW Donor. Please add me to the Donor’s mailing list of the Canadian Network to Abolish Nuclear Weapons.
Monthly Commitment A One-Time Gift
Please charge my credit card in the amount of:
$25 $50 $100 $250 $500 $1000 other $______
Name(s)* __________________________ Address* __________________________ City* __________________________ State/Province* _____________ Zip/Postal Code______________ Country* __________________________ Phone (______)___________________ Fax (______)___________________ E-mail ___________________________ Credit Card Type* Visa Mastercard Card Number* __________________ Expiration Date* ______/____________ I require tax receipt. (My contribution will be directed to the Canadian Network to Abolish Nuclear Weapons.)
Send any information package by regular mail.
I am enclosing a cheque. Please make cheque out to Project Ploughshares, and indicate that the donation is a contribution to CNANW.
Please contact us if you would like further information.
Thank you for your support.