Donation Form 1. Contact Information Name (required) Street Address City Province OntarioAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandQuebecSaskatchewanYukon Postal Code Phone Number (required) Email Address (required) If an organization, please provide contact information for a representative 2. Donation Donation amount Tax receipt issued for this amount. Registered Charitable Organization # 81381 0819 RR001 3. Privacy Waiver Friends of The OPP Museum may publish, post or otherwise disclose my name as a member and/or supporter in its publications and/or website along with the name of any person I associate with my donation. (Please be aware that in giving your permission you are also doing so for any other person you name in association with your donation.) I agreeI do not agree 4. Additional Donation Information I would like to make this donation in honour ofin memory of A note acknowledging this donation should be sent to: 5. Payment Information Payment will be made onlineOther (e.g. cash in person or cheque sent by mail) 6. Communication Preference Please send Friends of The OPP Museum correspondence, notices, publications, etc.: By regular mail to the address above By email to the address above By OPP internal mail to (Detachment/Bureau): Please DO NOT send any communication The information provided is collected by Friends of The OPP Museum in order to deliver its mandate as a registered charitable corporation to support and promote The OPP Museum and the history of the OPP. Except as may be required by law, it will not be disclosed without expressed written permission, and will be retained in accordance with our policy. Friends does not sell or otherwise provide member or supporter personal information to any other organization. Make a payment