Pledge Form Pajama Angels' YOGA 4 HOPE Event

Saturday August 23, 2014 | Vollmer-Outdoor Pavilion | 2121 Laurier Drive

First Name:

Last Name:

TAX RECEIPTS issued for $20.00 or more.

Please have a LEGIBLE & COMPLETE Mailing address.

_____________________________________

Yoga Studio/Team/Corporate Name/Individual :

Email:
Website:

PARKINSON SOCIETY SOUTHWESTERN ONTARIO

4500 Blakie Road, Unit 117 London, Ontario N6L 1G5
info@ParkinsonSociety.ca 1-888-851-7376
www.Parkinson.ca

Phone:

FULL NAME

ADDRESS, CITY, PROVINCE

POSTAL
CODE

PHONE
NUMBER

TAX

EMAIL

AMOUNT RECEIPT
PLEDGED Y/N

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

(attach more sheets if needed)

TOTAL AMOUNT $RAISED:

Thank You for Your Support in local cancers & chronic diseases through integrative health initiatives!
www.PajamaAngels.org | www.Yoga4Hope.ca | 519.796.9003 | info@pajamaangels.org
Pajama Angels United We Cure Not for Profit Incorporation # 1866938
Parkinson Society Southwestern Ontario Charitable Registration Number: 83130 2708 RR0001
2014 Benefactors:
Pajama Angels Wing Power Fund (Complementary Therapies Fund) & Parkinson Society Southwestern Ontario- monies will stay in Windsor-Essex