CCA - Donations and Trusts: Individual Cash Donations



	BMX Nationals Cyclo-cross Nationals MTB Nationals Para-cycling Nationals Road Nationals Track Nationals

	Canadian Team competing at:
	MTB

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	Road – UCI World Championships Sep.29 – Oct. 3, 2010 Melbourne, Australia www.melbourne2010.com.au/

	Cyclo-Cross – UCI World Championships Jan. 29-30, 2011 St-Wendel, Germany www.sankt-wendel.de/

	Track October 5-8, 2010 Delhi, India Commonwealth Games www.cwgdelhi2010.org/ December 2-4, 2010 Melbourne, Australia World Cup #1 www.trackworldcup.com.au/ December 16-18, 2010 Cali, Colombia World Cup #2 www.ciclismodecolombia.com/ January 21-23, 2011 Beijing, China World Cup #3 http://www.uci.ch/ February 18-20, 2011 Manchester, England World Cup #4 http://www.uci.ch March 23-27, 2011 Apeldoorn, Netherlands World Championships www.apeldoorn2011.com/

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INDIVIDUAL DONATION FORM

Name:__________________________________

Address:____________________________________________________________

Postal Code:___________________    Country:___________________

Donation Amount:_____________________

Donation Levels:
Supporter: $0 to $999   |   Friend: $1,000 to $2,499   |   Patron: $2,500 and over

METHOD OF PAYMENT

Cheque/Money Order:
Please make cheque/money order payable to Canadian Cycling Association (send via mail with completed form)

___ Visa   ___ Mastercard   ___ American express

Card #____________________________

Expiry Date:______________

Name on card: ____________________________

Signature: ____________________________ (mail in only)

Thank you for your support - it is greatly appreciated! A tax receipt will be mailed to you at the address indicated above.

Click here to print form.

203 - 2197 Riverside Drive, Ottawa, Ontario, K1H 7X3