Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Who's donating today? *Donating as an individualDonating on behalf of a corporation (no tax receipt provided)Donating on behalf of a Lions club (no tax receipt provided)Donation to ( Please Enter Employees Full Name)'s Fundraising Campaign *Employee Location *AbbotsfordAjax - SouthwoodBancroftBarrieBarry’s BayBowmanvilleBramptonBrantfordBrockvilleBurnhamBurlingtonBurnabyCalgary - BeddingtonCalgary - BonavistaCalgary - RockyviewCambridgeCambridge - PinebushCamroseCarbonearCasselmanChathamChestermereChilliwackCourticeDartmouth - AlderneyDelhiDorchesterCambridge - DeltaEdmonton – Bonnie Doon MallEdmonton – Heritage SquareEdmonton – John Roberts CentreEdmonton – NortheastEdmonton – Riverbend SquareEdmonton – West End Medical BuildingFort McMurrayFort St. JohnGlencoeGrande PrairieGravenhurstHaliburtonHalifaxHamilton LowerHanoverIngersollKamloopsKelownaKemptvilleKeswickKingstonKingsvilleKomokaLacombeLangleyLendrumLethbridgeListowelLondonMaple RidgeMidlandMiltonMindenMississauga Back OfficeMississauga - QueenswayMississauga - North ServiceNanaimoNapaneeNew WestminsterNewcastleNewmarketNiagara FallsNorth VancouverOakville - PostmasterOakville - TrafalgarOakville - Upper MiddleOrilliaOrleansOshawaOshawa - Keith Ross Dr (Taunton)Ottawa SmythParksvilleParry SoundPeace RiverPenetanguishenePort DoverPort ElginPort PerryPort UnionPrince RupertQualicumRed Deer SouthReginaRichmondRichmond HillRocklandSackvilleSaskatoonScarborough - Eglinton Ave (Brimley)Scarborough - Finch Ave (Bridlewood)Scarborough - LawrenceSelkirkSherwood Park – Synergy Wellness CentreSimcoeSouth SurreySpruce GroveSt BonifaceSt John'sSt. AlbertSt. CatharinesSt. ThomasSt. Thomas - Centre StStoney CreekStony PlainStouffvilleStratfordStratford 2StrathroySunridgeSurreyTerraceThoroldThunder BayToronto - BayviewToronto - Bayview VillageToronto – DanforthVancouver - ArbutusVictoriaVirgilWaterdownWaterloo - Boardwalk #430Waterloo - Erb StWaterloo II - Boardwalk #407WetaskiwinWhitby - Dundas St (West Lynde)Whitby - Brock St NorthWinnipeg - Crestview MallWinnipeg - Linden WoodsWoodbridgeYarmouthYorktonWhat type of gift would you like to give? *One-TimeMonthlyChoose your gift amount *$25$75$150$250OtherChoose your gift amount *$10/month$25/month$35/month$50/monthOtherCustom Amount *Company / Organization InformationEnter your company or Lions Club information below.Company / Organization Name *Company / Organization Address *Address Line 1City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonAlaskaAlabamaArkansasAmerican SamoaArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaGuamHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVirgin IslandsVermontWashingtonWisconsinWest VirginiaWyomingProvince / StatePostal Code / Zip Code--- Select country ---CanadaUnited States of AmericaCountryYour InformationName *FirstLastEmail *Phone *CommentsBilling InformationAddress *Address Line 1City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonAlaskaAlabamaArkansasAmerican SamoaArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaGuamHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVirgin IslandsVermontWashingtonWisconsinWest VirginiaWyomingProvince / StatePostal Code / Zip Code--- Select country ---CanadaUnited States of AmericaCountryPayment InformationCredit Card *E-CardSend an e-Card with this donationE-Card Recipient's Email *Choose E-Card Type *GeneralSympathyAnniversaryCongratulationsHappy BirthdayMother's DaySeason's GreetingsThank YouValentine's Day E-Card Preview E-Card Preview E-Card Preview E-Card Preview E-Card Preview E-Card Preview E-Card Preview E-Card Preview E-Card Preview Message to include in E-CardTotal Donation Amount$0.00Anonymous DonationMake this donation anonymousYour donation will remain anonymous and your name will not be printed in the annual reportDonation MatchingMy company matches donationsOur team will contact you to process any donations matched by your company or organization.Submit Donation
