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Step 1 of 3: Tribute card - Please provide the following information for your personalized card:

* Required information

Card Details *: In Honour In Memory

Personalized message for inside of card: (Please type in the box below)

Note: Text will appear exactly as entered, so please ensure accuracy of text and spelling. In addition, there is limited space available in the card, so please keep your message brief

Step 2 of 3: Tribute card - Send card to:

Title: Dr. Mr. Mrs. Ms.

First Name: *

Last Name: *

Address: *

Apartment/Suite:

City/Town: *

Province/State: *

Postal code/ZIP: *

Country: * Canada USA (Canada & USA only

Step 3 of 3: Donation and Card From:

Title: Dr. Mr. Mrs. Ms.

First Name: *

Last Name: *

Address: *

Apartment/Suite:

City/Town: *

Province/State: *

Postal code/ZIP: *

Country: * Canada USA (Canada & USA only

Phone: * () -

Email:

Na'amat Canada is dependent upon the generous support of donors and volunteers to fulfill its mission. If you would prefer not to receive communications from us, please tick this box.

Donation Amount: *
$18 (Pearl Level)
$36 (Ruby Level)
$54 (Diamond Level)

Credit Card Type: *
VISA
MasterCard

Card Holder Name: *

Card Number: *

Expiry Date: * 01 02 03 04 05 06 07 08 09 10 11 12 2008 2009 2010 2011 2012 2013 2014 2015

Special Comments or Instructions:

Privacy Policy:
Na'amat Canada respects your privacy and maintains high standards to protect the confidentiality of the personal information of our members and donors. The information that you provide will be used for purpose of keeping you informed of our objectives, services and programs as well as for processing any donation you make to support Na'amat. If at any time you wish to be removed from this list or from any future Na'amat mailings, simply contact us by phone at 1.888.278.0792 or via email at naamat@total.net. If you would like more information concerning Na'amat's commitment to safeguard your privacy, please contact our Privacy Officer at 1.888.278.0792.

A tax receipt for donations of $10.00 or more will be mailed. Na'amat Canada issues annual receipts at the end of the calendar year.

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