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Mail/fax donation form

All gifts to Inter Pares are tax-deductible (charitable registration number (BN) 11897 1100 RR000 1).

Please check this box if this is your first donation ever to Inter Pares.

You have the option of printing this form and filling it out by hand
or
filling it out and then printing it.

Mail or fax this form to:

Inter Pares
221 Laurier Ave., East
Ottawa, ON
Canada  K1N 6P1
Tel: 613-563-4801
Fax: 613-594-4704

First name (1):
Last name (1):
First name (2):
Last name (2):
Address:
City:
Province/State:
Postal/Zip code:
Country:
Telephone number:  
Fax number:
E-mail address:
Language: English French

In order to receive a charitable tax receipt, please ensure that your name and address are complete in the portion above.
Charitable Registration (BN): 11897 1100R0001

I would like to make a contribution now of:
$500   $250   $100   $50   $35   Other $

Payment method:
Cheque made out to Inter Pares
Credit card (please fill out the information below)
Money order


Credit Card Information:
Type: MasterCard   Visa
Name on card:
Credit card number:  ---
Expiry date: (month) / (year)

Signature: ____________________________________

Is this donation in honour of a person or an event? (If you would like a card sent to a recipient, please indicate the name and address to which it should be sent.)



In order to increase our support base we do, on occasion, exchange donor lists with like-minded, non-profit organizations. However, we do not exchange the names of donors who have requested us not to do so. To learn more about name exchanges, direct mail, and the role they play in Inter Pares' fundraising, please click here.

If you have any objection to having your name exchanged with other organizations, please check the box below:

No, please do not exchange my name

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Reviewed February 11, 2005 top Publishing Policies
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