YES! I WILL SUPPORT THE THYROID FOUNDATION OF CANADA!

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Thank you for choosing to support the Thyroid Foundation of Canada. Your donations help us to continue our programs of Awareness, Support, and Research.

PERSONAL INFO (as it will show on your receipt)

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GIFT MEMBERSHIP (enter recipient's information here)

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Required fields

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DONATION:

$25 CAD $50 CAD $100 CAD Other $ CAD General Donation (all donations support the work of the Thyroid Foundation of Canada)

In Memory of:

In Honour of:

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RECEIPT:

An official receipt for income tax purposes will be sent automatically to your email address for all membership fees and donations. (BN: 11926 4422 RR0001)

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PAYMENT:

We are the Face & Voice of Thyroid Patients in Canada

Membership Amount: $0.00 Donation Amount: $0.00 Total Amount: $0.00

Credit Card: VISA MASTERCARD Credit Card Number: Expiry Date: 01 02 03 04 05 06 07 08 09 10 11 12 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV number: What is this? Name on card:

Thyroid Foundation of Canada
P.O. Box 298
Bath ON K0H 1G0
CANADA

Tel: 1-800-267-8822

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