Celebration Donation

Gift Information

Tribute Information

I would like to make a gift in honour of:

First Name*
Last Name*
Occasion - Other

If you would like Vecova to send a card to inform the honoree of your gift (the amount is not included), please provide their mailing address below.

Notification Receipient Name:
Relationship to the honouree:
Notification Recipient Phone:
Notification Recipient Email:
Notification Recipient Street 1:
Notification Recipient Street 2:
Notification Recipient City:
Notification Recipient Province/State:
Notification Recipient Postal/ZIP Code:
Notification Recipient Country:
Message Body:
Message Signature:
Donation Amount*
  • $500.00
  • $100.00
  • $50.00
  • $25
  • Other $

Contact Information

Company name
Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
Communication
  • Yes, I would like to receive electronic communications from Vecova (including tax receipts).
  • No, thank you.

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code

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