Donation Form

To submit your donation by mail,
please print this donation form and mail to:
Family Services of the North Shore
203-1111 Lonsdale Avenue
North Vancouver, BC V7M2H4
Step 1 — Donor Information
Are you:
an Individual Donor
a Corporate Donor
If corporate donor please state organization name:
Step 2 — Gift Information
Thanks to caring people like you and the match from Northshore Auto Mall, your gift of *
$75 helps 2 children and youth in need
$375 provides 10 children and youth with hope
$750 allows 20 local children to find their voice
$1500 enables 40 local children and youth to thrive
Other Amount $.00

Is this:    a one time gift or    a monthly gift

Is there anything else we need to know about your gift?
My donation is for 
Specify person or occasion (if applicable) 

Please mail acknowledgement of this gift (for In Memory, In Honour or Special occasion gifts only) to:
Step 3 — Payment Information
Other Information

Tax receipts will be issued according to CRA guidelines. Tax receipts are issued for gifts of $20.00 or more, a gift of $500.00 or more is recognized in our Annual Report.

I would like my gift to remain anonymous
I would like to receive periodic updates from Family Services of the North Shore.

Simple Spam Protection Question:

Please, only press the Submit button once or multiple transactions may occur.