Donations to Maple Ridge/Pitt Meadows
Community Services
Please print and fill out this form for a tax-deductible contribution (charitable registration number 0394536-09-27)

Once completed, mail this form and cheque to:

Maple Ridge / Pitt Meadows Community Services

Attn: Director of Administration

11907 228th Street

Maple Ridge, BC, V2X 8G8

Please accept my tax deductible contribution of:

□$25             □$50           □$75          □$100         □Other: $___________
  ___ Cheque Enclosed (Please make payable to MR/PM Community Services.)
All contributions are tax-deductible as allowed by law.

Your Name: ___________________________________________________________________
Address: ___________________________________________________________________
City: ____________________________ Prov __________ Postal Code __________
...We thank you for your generosity...