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Tax Deductible Donation/Pledge form
Charity # 73797 7926 RR0001
Nourish Cowichan Society
#19 6870 Truesdale road
Duncan BC V9L 0B4
Name _______________________________________________________________________________
Address _____________________________________________________________________________
City _______________________________ Prov. __________________________P. Code __________
Email ______________________________________________________________________________
Total Donation/ Pledge $__________________________ one time_________ monthly _________
Cash __________ Cheque __________ E-transfer______________
Signature ________________________________
Copper $250.00 to $499.00 ___________ Bronze $500.00 to 999.00 __________
Silver $1000.00 to $2499.00__________ Gold $2500.00 to 4999.00 __________
Platinum $5000.00 to $9999.00 _______ Diamond $10,000.00 + _____________
We understand that you may want your generous donation to remain anonymous.
Please indicate below if we can celebrate your kindness with our supporters and viewers on our website & other forms of social media. Yes ____ No ____
Your positive impact will inspire others. All donations are tax deductible.
On behalf of Nourish Cowichan and the children we support,
we would like to thank you for your generosity
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