Gift Information
Donation Amount*
CAD20
CAD50
CAD100
Other $
Donation Frequency*
One Time
Quarterly
Monthly
Fund*
Individual Donation
Variety's Special Needs Program
Variety's Camp Brereton
Variety's Dental Outreach Program
Corporate Donation
Contact Information
This is a*
Personal Donation
Company Donation
Company Name
Email*
Country*
(None Selected)
Australia
Canada
Korea, Democratic People's Republic Of
New Zealand
Pitcairn
Trinidad And Tobago
United States
Zambia
State / Province*
Address*
City*
State / Province*
*
*
*
*
*
*
Confirm Email*
Phone*
Is this Gift in honour or in Memory of Someone?
Yes
(None Selected)
in honor of
in memory of
In Honour/ Memory of
Should we Send a Card/Email on your Behalf?
Yes, please send a card
Yes, please send an email
No thank you
Email Address of Person to Notify
Address of Person to Notify
City of Person to Notify
Province of Person to Notify
Postal Code of Person to Notify
Who would you like your email/card to be from?
Payment Information
Amount*
$
Payment Type
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to enter your card details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
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