The Scotch Road
Cemetery Association

Web site Donation/Bequest Form

I give and bequeath to The Scotch Road Cemetery Association, a non-profit group located in Grenville Quebec, the sum of [select one from below],

$30.00 $50.00$100.00$200.00$___________

as an unrestricted gift for its general purposes.

I wish to share my skills as a volunteer for The Scotch Road Cemetery Association. Please contact me.

Name: _______________________________________________

Address: ______________________________________________

Town/Prov: ____________________________________________

Postal Code: __________     Phone: ________________________

E-mail: _______________________________________________

An official income tax receipt will be issued for any donation or bequest over $10.00

Make cheque payable to "The Scotch Road Cemetery Association"

Send this form and your payment to:

The Scotch Road Cemetery Association
Apt 16
2168 Sherbrooke Street West
Montreal, Quebec
H3H 1G7

Thank you for
your support