PLEDGE FORM — Please use form to track cash and cheque donations
Kids Cancer Care Foundation of Alberta
Charitable Registration #89940 9171 RR0001
609 - 14th Street NW, Suite 302 T: 403 216 9210
Calgary, Alberta T2N 2A1
F: 403 216 9215
First Name / Company Name
Last Name
EVENT DATE:
LOCATION OF EVENT:
NAME:
ADDRESS:
Page ______ of ______
PHONE:
EMAIL:
FOR OFFICE USE ONLY
Address
City
Prov.
P:
C:
Postal Code
Phone
U:
Donation Type
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
Cheque
Cash
Mr. |
Mrs. |
Ms.
Email Address:
PLEASE NOTE THE FOLLOWING
Receipts will be issued for $20 or more but only if
the donor’s name and addresses are clearly printed
and complete.
Cheque
You may photocopy/
print additional pledge
forms as needed.
Please ensure cash & cheque donations submitted
add to what is stated on pledge sheet.
DO NOT INCLUDE ONLINE PLEDGES.
AMOUNT
$
$
$
$
$
$
$
$
$
$
Total Cash
$
Total Cheque
$
PAGE TOTAL
$
OFFICE - VERIFIED
$