Fillable Dear Fellow Optimists, (Optimist International)

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Dear Fellow Optimists, (Optimist International)

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Dear Fellow Optimists,
Rod McKendrick
2019-2020 CCOF President
Visit us on ccof-foec.org
5205 Metropolitain Blvd. E., suite 200, Montreal, Quebec H1R 1Z7
Tel: 1-800-363-7151 | 514-593-4401 poste : 336 Fax: 514-721-1104 info@ccof-foec.org
A donation for helping Optimists help Canadian kids.
Please send this form with your donation.
All donations are tax deductible. Only contributions of 20$ or more will receive a tax receipt.
The Canadian Children’s Optimist Foundation is a Canadian charity recognized by the Canada
Revenue Agency. Charitable Number: 874718950RR0001
THANK YOU FOR YOUR DONATION!
1. COMPLETE THE DONOR’S INFORMATION
First Name : _________________________________________________________________________________________
Last Name :_____________ ____________________________________________________________________________
Club/Org/Business name: ______________________________________________________________________________
(FOR CLUB, ORGANIZATION OR BUSINESS DONATIONS)
Address: __________________________________________________________________________________________
City : ______________________________________________________ Prov.: ______ Postal Code : __________________
Member/Club Number : ________________________________ Telephone: ____________________________________
(MANDATORY IF APPLICABLE)
E-Mail : ____________________________________________________________________________________________
2. CHOOSE A TYPE OF GIFT
UNRESTRICTED GIFT
$36.50 $250 $500 $1 000 $_________
Dime-a-Day Presidents Club Friend of the Foundation Christian D. Larson Other amount
New Renewal Partners
RESTRICTED GIFT
$ ________________________
Outsourcing Project
Project number : __________________________________________
DFR’s information
DFR Name : _____________________________________ District Number :______ Date :________________________
THIS DONATION IS IN MEMORIAM IN HONOR
I need a NAME PATCH | minimum of $100 donation for a name appliqué
CCOF BANNER PATCH | please check if you need the CCOF In Memoriam or In Honor appliqué
Deceased / Honored person: ___________________________________________________________________________________
Person to notify: _____________________________________________________________________________________________
Address: _________________________________________________________________________________________________
Person who will receive the patch: _______________________________________________________________________________
Address: _________________________________________________________________________________________________
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Dear Fellow Optimists, (Optimist International)

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Completed 30 July 2020

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