UPPER GRAND LEARNING FOUNDATION

500 Victoria Road North, Guelph, Ontario N1E 6K2

Charitable Registration Number 89445 0444 RR0001

CONTRIBUTION FORM

Name ___________________________________________________________

Address _________________________________________________________

_______________________________________________ Postal Code_______

Please accept my gift of $________________________

Donor(s) Signature(s) __________________________________________________________

Method of Payment

A. Enclosed is my cheque ________________________
(Please make payable to: Upper Grand Learning Foundation)

B. Charge my VISA_____ MasterCard________ Card Number________________________

Signature________________________________ Expiry Date_________________________

Please credit my gift to (circle your choice) :

A. General Fund – I want to donate to these unrestricted funds accessible to schools and community groups for educational programming or activities. Applications for these funds are reviewed by UGLF and funds are disbursed according to funds availability.

B. School Fund – I want to designate my donation to:
____________________________________________________________________________
Name of school(s)

C. Scholarship Fund – I want to donate a Scholarship to a particular school; I have discussed my intention with that school’s Principal and/or Guidance Head; I have completed the Scholarship Agreement with UGLF.

D. Sponsor an Award – to recognize student achievement at:
____________________________________________________________________________
Name of school(s)

Please forward your donation and completed Contribution Form to the Upper Grand Learning Foundation at the above address or to the attention of Upper Grand Learning Foundation through your nearest Upper Grand District School Board school’s courier service.

Tax receipts will be issued for contributions of $10 or more. For more information, please see our Privacy Policy.