Donate Now

Your Contact Information

Please complete the form below
Your contact information and e-mail is required to send you a charitable tax receipt.

If you require a receipt in your name please choose the Individual option below

If you require a receipt in the name of your company or business please choose the Company representative option below
* Required Field
Title: *
First Name: *   
Last Name: *
E-mail Type: *
E-mail: *
Confirm e-mail: *  
Address Type: *
Country: *
Address: *
City: *
Province / State: *  
Postal Code / ZIP: *  
Phone Type: *
Phone: *      Phone Extension:
Comodo Trusted Site Seal

About Us | Privacy Policy | Contact Us | Terms of Use Refunds
Copyright © 2017 Kids Cancer Care Foundation of Alberta. All rights reserved.