YES! I want to make a donation to protect nature in Canada. $100   $200   $500 Special amount $________
Print out this form, fill it in and send it to Nature Canada by fax or mail.
75 Albert St., Suite 300 Ottawa, Ontario, Canada K1P 5E7	FAX 1-613-562-3371

Name:

Address:

City:

Prov/State:     Postal Code/Zip Code:

Email:

METHOD OF PAYMENT:
Cheque (enclosed) 

VISA   MasterCard   American Express  

Card #: Expiry date:

Signature:

Thank you for supporting Nature Canada!

Nature Canada is a registered charity and issues tax receipts. Our charitable registration #11883-4704-RR0001.