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In Support of
21st Annual Charity Bowl-a-thon
Thursday,
Thursday, May 7, 2015 – 6:00pm – 8:00pm
Burlington Bowl, Harvester Road & Walkers Line
Please fax or email your completed donation form to the attention of Leah May,
fax: 905905-637637-5404, email: [email protected] on or before April 30,201
30,2015
2015.
DONATION INFORMATION FORM
NAME:
____________________________________________________________
COMPANY:
____________________________________________________________
ADDRESS:
____________________________________________________________
____________________________________________________________
EMAIL ADDRESS:
____________________________________________________________
PHONE NUMBER:
____________________________________________________________
GIFT DONATIONS:
WHAT IS YOUR GIFT DONATION?
___________________________________________
WHAT IS THE APPROXIMATE VALUE OF YOUR GIFT DONATION? $
CASH DONATIONS:
[ ] Lane Sponsorship (min. $200.00 please) $
Name to appear on your lane sign:
Please Note: New Corporate Lane Sponsorships must be submitted no later
later than April 23,2015 in order for signs to be ordered. Recurring
Corporate Lane Sponsorships must be submitted by May 1st, 2015.
[ ] Cash Donation
$
Please make cheques payable to “Martin
Martin & Hillyer – Charity BowlBowl-A-Thon”
Thon” and mail to: Leah May
C/O Martin & Hillyer
2122 Old Lakeshore Road
Burlington, Ontario
L7R 1A3
Alternatively you may authorize Martin & Hillyer Associates to charge the above specified amount (lane sponsorship
and/or cash donation) to your credit card.
[ ] VISA
[ ] MasterCard
Name of Card Holder: ___________________________________________________________
Credit Card #:
___________________________________________________________
Expiry Date:
________________________
Signature:
___________________________________________________________
CSV: _______________ (3 digits on back of card)
Nelson Youth Centre Registered Charitable # 119053395 RR 0001