NBRS Printable Donation Form

“Charles MacColl Internship Program Legacy Circle”

Please send card to:
Name:  
Address:   Apt.:  
City:   Prov.:   Postal Code:  
Country:  
Telephone:   Email:  

 

Donor Information:
Name:  
Address:   Apt.:  
City:   Prov.:   Postal Code:  
Country:  
Telephone:   Email:  

 

Step 1: Donation Amount

Yes, I'd like to support the “Charles MacColl Internship Program Legacy Circle”.
(please mark an 'X' next to each option you select)

__ Charles MacColl Legacy Circle - $1500 (NBRS 10 year Member)

__ Corporate Circle amount: ___________

__ Additional donation amount: ___________

 

Step 2: Payment

Cheque, payable in the amount of $______________ to The National Broadcast Reading Service Inc., is enclosed.

OR

Charge the amount of $______________ to my:

Visa or MasterCard (circle one)

Card No.: ____________________________________________


Expiry Date: ___________________


Signature: ___________________________________________


Today's Date: __________________

We will issue a tax receipt for donations of $10 or more.
Charitable registration no: 128778552RR0001

Early in the new year we will send you an official receipt for your total annual contribution.

Mail to:

    The National Broadcast Reading Service Inc.
    303-1090 Don Mills Rd., Toronto, ON M3C 3R6
    Phone: (416) 422-4222 x 225
    Toll-Free: 1-800-567-6755
    Fax: (416) 422-1633

THANK YOU for your consideration!

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