Corporate Donation

Company Name:
Contact First Name:
Contact Last Name:
Address Line 1:  *
City:  *
Province / State:
Postal Code / Zip:  *
Phone:  *
(for receipt)
Donate to:
Donation Amount:  $500
Or Other Amount $:  *
Amount should be only in numbers
We incur a small processing fee which is deducted from the full amount of your donation. Would you consider paying this small fee on behalf of Kinsmen Lodge?
Include Fee: Yes   No
How did you hear about us? (choose one):
If 'Other', please specify: