Make a donation - Répit Le Zéphyr

Form

Donor
With your donation, as well as those of other donors, we will be able to offer respite care to families at a reduced rate so they can more easily benefit from our services. Thank you for your support!

To make a donation by cheque, download our printable coupon.
Case pour entreprise
Organization name
First name*

First name
Last name*

Last name
Address*

Address
Office/Apartment (optional)

Office/Apartment (optional)
City*

City
Province*
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal code*

Postal code
Telephone
Email

Email
Donation amount*
- 25$
- 50$
- 100$
- Other
Other
Total:
0.00 $
Request a tax receipt
¹A tax receipt will be issued for donations of $25 or more.

Donation by cheque

If you prefer to make a donation by cheque, download the printable form and return it with your cheque to the following address:

663, boulevard Bord-de-l'Eau
Salaberry-de-Valleyfield, Quebec J6S 0B5
450 371.6825 Ext. 208

To the attention of:
Isabelle Corbeille, Executive Director