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The Winnipeg Ostomy Association's
Charitable Donation Page

Registered Charity

If you wish to make a donation to The Winnipeg Ostomy Association:
Please print this form, fill in the information (please print) and mail to:

The Winnipeg Ostomy Association,
204 - 825 Sherbrook St. Winnipeg, MB
Canada  R3A 1M5

Name: ...............................................................

Address: ............................................................

City: ...............................................................

Province: ....................   Postal code: ................

Telephone: (........).........................................

Email: .......................................................

Amount of donation: (please check) 

$100 _____ $50 _____ $25 _____ $10 _____ Other $_____ 

A tax receipt will be sent to you for donations over $10.00.
(The Winnipeg Ostomy Association is a not-for-profit registered charity.)
__________________________________________________________________________

If you desire, your donation may be made in memory of someone. 
If you wish, a card can be sent as an acknowledgement of your donation.

This donation is in memory of: (First and last names) ............................................
Please send acknowledgement of the donation to: 

Name: ...............................................................

Address: ............................................................

City: ...............................................................

Province: ....................   Postal code: ................

Thank you for your consideration and generosity. 
It is greatly appreciated and your donation will be put to good use
helping people with ostomies in Manitoba.
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