Adopt-A-FamilyDonorApplication-ClosertoHome：adopt-a-family供体应用离家更近的地方.docVIP

Adopt-a-Family Donor Application Form This form will be used to match each child or family with a donor. Please forward completed form to the Closer to Home office (3507A – 17 Avenue SW, Calgary, AB), email to aaf@ or fax 403-246-6406 ATTN: Adopt-a-Family Program. Please complete your contact information Application Date Donor(s) Name Contact Person Address City Province Postal Code Email Daytime Phone Other Contact Number Do we have permission to include your name in Closer to Home publications such as our annual report or quarterly newsletters? Yes No Would you like a tax receipt for your donation? If so, please submit receipts to the CTH Fund Development Department by December 31 Yes No How Did You Hear About Closer to Home and the Adopt-a-Family Program? Calgary Academy Newsletter CTH Website Campaign Flyer Mass Email Sponsor Energy CTH Employee (please provide name of employee): Gift Donations (complete section if you would like to purchase gifts for a child/family) If applicable, would you be available to deliver these gifts to your recipient? Yes No Would you like to sponsor a whole family? If yes, what size family? people Yes No Would you like to sponsor a single child? If yes, what age/gender? Age Male Female Yes No Cash Donations (complete section if you would like to donate funds for a child/family) Would you like to donate cash/cheque? Cash form lease email ( at Cheque $ Please designate my donation to: Adopt-A-Family Program Where it is most needed Other: Additional Comments 3507A – 17 Avenue SW, Calgary, AB T3E 0B6 Tel: (403) 543-0550 Fax: (403) 246-6406 aaf@ Charitable Registration #: 89823 5759 RR0001 Thank you so much for