United Nations Association in Canada
MAIL-IN GIFT FORM - Donations & Membership

pdf version here

DONOR INFORMATION

Title (Mr., Mrs., Ms., Dr. etc.): _______________________
Surname: ________________________________________
Given Name(s): ___________________________________
Address: ________________________________________
City: ___________________________________________
Province: ____________ Postal Code: _________________
Home Telephone (opt.): (_____)_________________
Work Telephone (opt.): (_____)_________________
Email (opt.): ______________________________________

O - I would like to receive occasional (4-8/year) email updates on UNA-Canada activities. (Please provide email)
O - Please do not trade my name with other organizations.
O - No, I am not interested in being informed about activities organized in my community. Please do not share my name with the local Branch of UNA-Canada. (This option only relevant if you live in the vicinity of a Branch)
O - Please do not add me to UNA-Canada's mailing list.

UNA-Canada rewards its community-based Branches for finding new supporters. If this is your first gift and if you learned about us from a Branch, please indicate which Branch should be acknowledged: _______________________ (Branch options listed below in "gift designation" section)

GIFT INFORMATION

I would like to make a gift of: $ ____________ (Canadian dollar is assumed, unless you specify otherwise)
OR I want to be a "Friend of the Charter" and wish to donate $ ___________ (minimum $1,000)

O - I have enclosed a cheque made payable to the "United Nations Association in Canada" or "UNA-Canada"
O - I prefer to pay by credit card (we accept VISA or MasterCard)

Card Number: __________________________________________
Expiry Date: ____________________________________________
Name as it appears on card: ________________________________
Signature: ______________________________________________

I would like to designate my gift as follows (please choose only one option):

O - Membership (become a member both nationally & locally in one step)
O - General gift to UNA-Canada (national programmes, used wherever need is highest, NOT membership)
O - Donation to UNA-Canada's Branch in (100% goes to Branch, NOT membership)
Branch options are: Victoria, Vancouver, Kootenay Region, Edmonton, Calgary, Winnipeg, Toronto, National Capital Region, Hamilton, Quinte Region, Montreal, Saguenay/Lac-St-Jean Region, Quebec, St. John's. Please do NOT make the cheque out to the Branch, we will forward the $.
O - National Reserve Fund (invested for 10 years, provides long-term stability)

A charitable tax receipt will be issued.
Charitable Registration No. 11927-6855 RR0001

Please return this form to:

United Nations Association in Canada
300-309 Cooper Street
Ottawa, Ontario K2P 0G5
Fax: (613) 563-2455

Thank you so much for your support!