Page 59 - Living Confidently with a Food Allergy
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Mail to:
Food Allergy Canada
Head Office
T • 416-785-5666
2005 Sheppard Avenue East, Suite 800
Toronto, Ontario M2J 5B4
T • 1-866-785-5660
F • 416-785-0458 info@foodallergycanada.ca
Please complete this form and mail or fax it to Food Allergy Canada
Name _______________________________________________________________________________________ Address ____________________________________________________________________________________ _____________________________________________________________________________________________ Phone Home ____________________________ Mobile ________________________________ Email _______________________________________________________________________________________
I give Food Allergy Canada permission to contact me by mail.
Western Region Office
T • 250-314-4814
T • 1-877-322-9378
F • 1-888-872-6014 acwest@foodallergycanada.ca
I give Food Allergy Canada permission to contact me by email.
Donation
I wish to become a member of the Future of Hope Monthly Giving Club. Monthly donation amount: $ _____________
I wish to make a one-time donation of: $25 Method of Payment
$50 $100 Other: $ _______________
My cheque is enclosed (Payable to Food Allergy Canada)
I will pay by credit card: Visa / Mastercard / American Express (circle one)
Card Number: _________ / __________ / __________ / __________ Expiry: _____ / _____ Card holder’s signature: ___________________________
Food Allergy Canada is a registered charitable organization in Canada. Charitable Business #887208676RR0001 Please note receipts will be provided for donations over $20.00 CDN.
Thank you for your support!
Living Confidently with Food Allergy – Page 59
Show your support today. A donation to Food Allergy Canada will help fund programs and services like the Newly Diagnosed Support Centre. Your generous donation will help families affected by life-threatening allergies.
