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Gift Information

Field Is Required Select A Gift Amount:

Donor Information


The email address entered MUST belong to that of the donor in order for the receipt to be issued in the donor’s name. If you do not have the donor’s email address, please use this email format in order to have the receipt sent via Canada Post:
donorfirstname.donorlastname@walkforalzheimers.ca (example: john.smith@walkforalzheimers.ca).

Billing Information

Payment Information

Credit Card Information:

Credit Card Type:
  • Visa
  • Discover
  • American Express
  • MasterCard
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