Niagara Peninsula Children’s Centre   Donation Form

With your gift, you will not only help children receive excellent therapy programs, but you will also be helping them in working towards being happier, healthier, and more independent individuals.

*A child’s future could depend on you.

Yes I want to help, please accept the following donation:  

NAME: Check One Mr.___ Mrs.___ Miss___ Ms___

ADDRESS: ________________________________________________

CITY: ____________________________________________________

COUNTRY:_______________________PROVINCE/STATE:____________

POSTAL CODE: _ _ _- _ _ _   ZIP CODE:______________

Enclosed is my gift for: Check One $20.00___ $50.00___$100.00___$150.00___

$1000.00____Other: $_____

Please accept my payment by: Check One

VISA__MASTERCARD__AMEX__CHEQUE__CASH__OTHER________

Card #________________________________________________

Reason for donation: ________________________________________

Mail to:

Niagara Peninsula Children’s Centre Foundation

567 Glenridge Avenue, St. Catharines Ontario, L2T 4C2

For further information on the Niagara Peninsula Children’s Centre visit www.npcc.on.ca or to keep checking back to this website for upcoming events in support of the NPCC.

*We are a member of the Ontario Association of Treatment Centres (OACRS)

Charitable Registration Number: 890468994RR0001