VILLA CHARITIES DONATION FORM
Please print, complete & mail form to
Villa Charities Foundation 901 Lawrence Ave W. Toronto, Ontario M6A 1C3
Thank you for your donation!    Grazie Mille!
DONATION IS BEING MADE BY:
 DONOR NAME
ADDRESS

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AMOUNT DONATED $ In Honour of    In Memory of
METHOD OF PAYMENT:
 Cheque    Money Order    Visa    MasterCard    American Express

Card Holder Name:

Card No.:

Expiry Date:

Signature:
ACKNOWLEDGEMENT TO BE SENT TO:
MESSAGE ON CARD:
FOR OFFICE USE ONLY

DATE RECEIVED DAY / MONTH / YEAR

ACKNOWLEDGEMENT SENTDAY / MONTH / YEAR

COMPLETED BY:
Charitable Business Number: 89337-0767-RR0001 svdsfm0301