Loads of Love, Chatham, Ontario - Mail-In donation Form

For Mail-In Donations

Please Print, Fill In and Mail this Donation Form Along with your Cheque or Money Order to:

Loads Of Love
15 Prince St. N
Chatham, ON
N7M 4J5

 

Amount: $_________


Designation of Funds: ___________________________


Donated by:

Name:___________________________ Phone (____) ____________

Address:_______________________________

City:_______________________________

Province:___________________________

Postal Code:________________________

 

Donor Signature_______________________Date_____________