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CRC OZ YOUTH FUNDRAISING SUBMISSION FORM Return completed form and funds to: Michelle Wallis, OZone Dept of Philanthropy Date: ___________________________ Received By:___________________________

CONTACT NAME/ORGANIZATION REPRESENTATIVE: Svetlana Ageeva ADDRESS: c/o 5700 Cancross Court, Mississauga, ON L5R 3E9 CONTACT NUMBER: 905-890-1000 ext. 274 EMAIL ADDRESS: svetlana.ageeva@redcross.ca CO-ORDINATOR (Relationship tab): GROUP NAME/LOCATION/BRANCH CRC OZ YOUTH EVENT NAME/DESCRIPTION HOW FUNDS WERE RAISED (Gift Notes)

CASH AMOUNT $________ CHEQUE AMOUNT $________ NUMBER OF CHEQUES QTY _____    

COLLECTION  TAX RECEIPTING REQUIRED  (Please attach receipting form with full mailing addresses & donation amounts)

FUNDRAISING COMPLETE Y  N 

CAMPAIGN: 140 FUND: 300 Default unless otherwise designated: ____ APPEAL: YOUTH ACTIVITIES PACKAGE:

RE ID#__________

SPECIAL INSTRUCTIONS (for admin.) 1. Please use new naming convention, all groups start with CRC OZ YOUTH followed by Group Name/location


Fundraising Form