Gift of Love Ticket Purchase and Donation Form

CONTACT INFORMATION

Contact Name*

First Last

Is your purchase private or on behalf of a company?*

Private
Company

Company Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

TICKET PURCHASE

Please indicate if you would like to purchase individual tickets or a table of 8.

Individual Ticket
Table

Number of Individual Tickets*

Price: $ 225.00 CAD Quantity:

Tickets are $225 each. You will receive a $105 tax receipt per ticket purchased.

Number of Tables*

Price: $ 1,800.00 CAD Quantity:

A table of 8 is $1,800. You will receive a $840 tax receipt.

Seating Request

PAYMENT INFORMATION

Total Due

$ 0.00 CAD

Payment Method*

Invoice (via email)
Credit Card
Cheque

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Please make cheques payable to Canuck Place Children's Hospice - Gift of Love and send to: 1690 Matthews Ave, Vancouver, BC V6J 2H2.

TAX RECEIPT INFORMATION

Tax Receipt Information*

Please issue a tax receipt to the name provided above.
Please issue a tax receipt under a different name and address.

Name*

First Last

Tax Receipt Address*

Tax Receipt Total

The Canada Revenue Agency has specific rules regarding tax receipting of charitable events. The amount eligible for an official donation receipt has been determined within these parameters.

ADDITIONAL QUESTIONS OR COMMENTS

Message

CONTACT INFORMATION

TICKET PURCHASE

PAYMENT INFORMATION

TAX RECEIPT INFORMATION

ADDITIONAL QUESTIONS OR COMMENTS

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