Brant County Branch Canadian Mental Health Association How to Donate

Brant County Branch

CANADIAN MENTAL HEALTH ASSOCIATION, BRANT COUNTY BRANCH
MEMBERSHIP AND DONATION FORM
I wish to become a member of C.M.H.A. for $20.00 __ I am a consumer/survivor and wish to be a member for $8.00__ I wish to purchase a corporate membership for $50.00__ I wish to make a donation in support of C.M.H.A. __ Please Circle One: $30.00 $50.00 $100.00 $200.00 Other:_______
Name:_________________________________________________________ Address:______________________________________________________ Postal Code:_______________ Telephone:________________________
You will receive a receipt for your donation. I wish to share my skills as a volunteer for C.M.H.A. ______ *Please make cheques payable to:* Canadian Mental Health Association, Brant County Branch 44 King St. Suite 203, Brantford, ON, N3T 3C7 Telephone: (519) 752-2998