One-time donation form - CancerCare Manitoba Foundation

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Donations to CancerCare Manitoba Foundation help support cancer prevention in our province. All funds donated remain in Manitoba supporting an internationally-recognized team of health professionals at CancerCare Manitoba who provide outstanding care for patients and their families dealing with a cancer diagnosis.

Gift Information

Field Is Required Select Gift Amount:

$1,000.00

$500.00

$250.00

$100.00

$50.00

$25.00

Other (min. $15.00 for tax receipt)

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Yes, I would like to make this donation anonymously

(On second thought, I would like to consider a monthly gift.)

Donor Information

This form does not support personalized auto-fill settings. Please double check all fields before submitting.

Is this a donation from a company?

Yes

Title:

First Name:

Last Name:

Contact First Name:

Contact Last Name:

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Please enter the donor email address. If an email address is not available, please enter their first and last name within the following format: firstnamelastname@noemail.ca (e.g. JaneSmith@noemail.ca). A tax receipt will follow by mail.

Email Address:

Yes, I would like to receive electronic communications from CancerCare Manitoba Foundation.

If you are registered for a CancerCare Manitoba Foundation fundraising event, please ensure the box is checked to continue receiving event communications from the Foundation. (We do not rent, sell or trade mailing lists or other personal information.)

Billing Information

Billing information is the same as donor information

Title:

First Name:

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Street 2:

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Country:

Payment Information

Card Information

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Expiration Date:Select month of credit card Select Expiration Year

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