Please complete the following form, print and mail to:
Couchiching Jubilee House
P.O. Box 272
Orillia, Ontario
L3V 6J6
 
Tax-deductible receipts will be issued for income tax purposes.  Thank you for your generosity in supporting our work.

Couchiching Jubilee House
I am pleased to make a donation to support the work of Couchiching Jubilee House in the amount of $ ______________________
Name: _____________________________________
Address: ___________________________________
___________________________________
This donation is given in memory of: ______________________________________
This donation is given as a tribute to: ________________________________
Please send a note to the following person/family notifying them of the donation made on their behalf:
Name: ______________________________________
Address: ____________________________________
Please send cheque/money order to:
Couchiching Jubilee House P.O. Box 272 Orillia, Ontario L3V 6J6
Charitable Donation Number 87282 4610 RR0001