Adopt-an-Acre On-line form

ADOPT-AN-ACRE
On-line Donation Form

Directions: You may complete this on-line form and SUBMIT it to the LRCA. We will process your donation once we receive your pledge in the mail.
This form is also available in a Mail-in version, which you can output with your browser's PRINT command.

A charitable receipt will be issued in the amount of the donation and a certificate and window decal will be sent to the donor. Complete the information as you wish it to appear on the certificate and correspondence.

Yes, I (we) want to be part of the Adopt-an-acre program!

Donor information:

Name:

Address:

City: Prov.: Postal Code:

Phone: (optional)

Wording on Certificate
Donation from:
OPTIONS:
On behalf of:
In memory of:
DONATION AMOUNT
# of Acres:
@ $25 per acre
Total Gift = $
Yes, I wish to be a Sustaining Conservationist ($500 one-time donation for one acre) Please SUBMIT this form by clicking on the button below. Next, send a cheque in the amount of your pledge to: Adopt-an-Acre Lakehead Region Conservation Authority P.O. Box 10427 Thunder Bay, ON P7B 6T8 We will process your donation and issue the certificate, decal and tax receipt once we receive your cheque in the mail. ~ Thank you for being a part of Adopt-an-Acre ~

Use the PRINT command in your browser if you wish to print out the blank form.

Return to Adopt-an-Acre page.

Go to Adopt-an-Acre Mail-in form.

Lakehead Region Conservation Authority
P.O. Box 10427; 130 Conservation Rd.
Thunder Bay, ON P7B 6T8 (Canada)
Telephone:(807) 344-5857 Fax:(807) 345-9156

Donor information:
Name:
Address:
City:	Prov.: Postal Code:
Phone: (optional)