Box 228, Park Drive Villa, Williamsburg, Ont. KOC 2HO
Phone: 613-535-2215 Fax 613-535-1749
My donation of $ ______________ is enclosed.
Please make all cheques payable to:
Please
send me a receipt for Income Tax Purposes.
Dundas County Hospice.
I would
like to volunteer my time and energy.
Charitable Registration No.
I would
like more information about hospice programs.
89131 6382 RR0001
I would
like to become a Dundas County Hospice member (fee - $10.00).
NAME: _______________________________________________________________
ADDRESS: ____________________________________________________________
____________________________________________________________