The Chill Foundation · Chill Donation Form

Enter Donation Amount *
$1,500 - Includes invite to Chill's donor recognition event in March
$1,000
$500
$100
$75
$50
$30

$

Recurring Payment Schedule

Donation Designation

*

To designate your gift to a local site, choose a city from the following list, otherwise select Canadian National .

Contact Information

Are you making this donation as an individual or business/organization?

*

Individual

Business/Organization

Organization/Employer

*

Name

*

First Name

Last Name

Preferred Email

*

Home Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Is this a tribute gift?

*

No

Yes, in honor of

Yes, in memory of

Name of the person this gift is honoring or in memory of

*

First Name

Last Name

May we notify the honoree of your gift by email?

*

Yes

No

Honoree's email address

*

May we notify a family member or friend of your gift?

*

Please note: In some cases families have requested Chill notify them with the names of all donors, we do not disclose donation amounts.

No

Yes, by email (Donor to provide)

Yes, by email (Chill please use family email on file)

Yes, by mail (Donor to provide)

Name of family or friend to notify

*

First Name

Last Name

Family or friend's email address

*

Family or friend's Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country