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Membership or Donation

Membership or Donation

BCSS Membership & Donation Form

Please consider helping us keep our doors open by becoming a member or giving a financial donation to Breast Cancer Support Services. You will be making a difference by helping us offer emotional support and much needed resources and coping information to thousands of people and their families journeying with breast cancer today.

For more information on Planned Giving, please click here.

Contact information

My donation/membership is being made in the name of an individual or organization.
Individual     Corporation

I am supporting BCSS because:

I am responding to the letter that I received in the mail.

I have attended a Breast Health Workshop.

I have/someone in my family has used the services at BCSS.

Other:

 

Organization Name :
(if applicable)
Name :
Address :
Apt # / Unit# :
City :
Province :
Postal Code :
Phone Number :
Email Address :

 I am making a donation       I would like to be a member ($10.00)

We gratefully accept donations in memory/honour of friends and families and would be happy to acknowledge your gift with a letter.

In Memory Of :
In Honour Of :
Specific Fund:

Please send gift acknowledgement to:

Name:
Address:
City/Prov:
Postal Code:

 

My donation is under $20.00 and I would like to receive a tax receipt.

Tax receipts for donations under $20.00 will be provided upon request.

All donations are in Canadian Funds
Click below to secure your payment online.
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