Make a donation

Please note: The information provided here must be identical to the information associated with the credit card used for the donation.

First name*

Last name*

Nickname (to replace your name on public display)

Email address*

Civic number and street*

Suite

City*

Province*

Postal Code*

Country*

Your message of encouragement

What is your age group?*

Do not produce a tax receipt for this donation

I would like my donation to be visible (identity and amount) I would like to control what is publicly displayed (anonymity options)

I agree that the participant or team leader I am supporting may receive upon request my name, company name and email address given in this form for thank you or solicitation purposes. The Charles-Bruneau Foundation cannot be held responsible for its use once shared.

Yes

Subscribe to the newsletter

By making a donation, you agree to be on our donor list for future solicitations. You may withdraw your consent at any time by emailing us at fondation@charlesbruneau.qc.ca. Personal information is collected and stored in compliance with the law on the collection and protection of personal information. For more information, please consult our privacy policy.

Donate

I donate to: IGA - LES OPS DE QUÉBEC

Donor’s informations