Walk Event to Support Alzheimer Society

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Gift Information

Field Is Required Select A Gift Amount:

$10.00

$25.00

$50.00

$75.00

$100.00

Enter an Amount

Enter amount

Gift Recognition

If you are making a donation on the behalf of someone else, please enter their name below.

You can also use this field to record how you would like your donation to appear on the recipients donor wall (eg. John Smith, or Smith Family for example).

Yes, make this an anonymous gift.

Recognition Name:

Yes, you can display the amount of my donation publicly

Personal Note:

Donor Billing Information

Title:

First Name:

Middle Name:

Last Name:

Address (line 1):

Address (line 2):

Address (line 3):

City:

Province / State:

Postal Code / Zip Code:

Country:

The email address entered MUST belong to that of the donor in order for the receipt to be issued in the donor’s name. If you do not have the donor’s email address, please use the email format in order to have the receipt sent via Canada Post:
donorfirstname.donorlastname@walkforalzheimers.ca (example: john.smith@walkforalzheimers.ca).

Email Address:

Yes, I would like to receive email from Alzheimer Society.