2009 Individual Giving Campaign

Donation Form

*First Name

*Last Name

* Address line 1

Address line 2

City

Province/ State

*Postal Code/ Zip Code

*Email address

*Phone Number

Donation Amount:   $25 $50 $100 $500 $1000 $2000

Other Amount:

Method of Payment   Visa Mastercard

Full Name on the Credit Card

PLEASE Do not record your credit card number or expiry date on this document. A member of our staff will contact you to confirm your payment details. Thank you for your support of the work we do.

Please recognize this contribution under the following name:

I would prefer my donation to remain ANONYMOUS.   Yes No

Privacy Policy: Quest Theatre does not buy, sell or trade your personal information with other organizations. By providing such information, you give Quest Theatre consent to contact you from time to time throughout the year, to inform you of special events, campaigns and public performances.