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Yes! I want to help CAP continue to improve the
quality of life for people affected by Porphyria!

The Canadian Association for Porphyria is federally registered as a nonprofit charity in Canada
(#11883 5305 RR0001).
Tax receipts will be issued for donations over $10.

or donate online through

 

Gifts made using Visa or MasterCard can also be faxed to 1-204-476-2800
or mailed to the national office address (below) with this form:

Donor Information: (click here for printable version)

Name___________________________________________________________

Address_________________________________________________________

City_____________________ Province___________ Postal Code___________

Phone No_____________________ E-mail Address______________________

Payment Information:

Donation Amount

[  ]   $25          [  ]   $50         [  ]   $100          [  ]   $200         [  ]   Other______________

Credit Card Type

[  ] VISA        [  ] MasterCard        Card Number_________________________

Name on Card _________________________ Expiration Date____________

Signature _____________________________________________________

Gifts made by cheque (made payable to the Canadian Association for Porphyria) should be mailed directly to the Canadian Association for Porphyria's national head office:

Canadian Association for Porphyria
P.O. Box 1206
Neepawa, Manitoba     R0J 1H0
Canada

There are many ways that you can help the Canadian Association for Porphyria grow!  Here are some ideas for ways that you can contribute to the CAP:

	In memory of a loved one, or someone who has made a difference
	In recognition of a special person, or event (birthday, anniversary, wedding, graduation, or other celebration)
	Suggest that a community fundraiser, such as a curling bonspiel, golf tournament or concert, donates proceeds towards CAP programs
	Help us sell raffle tickets and cookbooks in your area

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