Donation Form

To make a donation, please complete the form below.
Your contribution is integral to the success of our fundraising event.
The Reliance Golf Tournament committee thanks you for your support.

If you are interested in becoming a Sponsor, please click here for more information.

* Indicates required field

Name *

First

Last

Company Name *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Donation Type *

Monetary (Please complete payment information below) Prize/In-kind (Please complete details below)

Phone Number *

Monetary Donation Amount *

Prize/In-kind Description (Please include description and approximate value) *

Select Method of Payment *

Company Cheque (Payable to: Reliance Products Ltd. Mail to: Reliance Products 1093 Sherwin Rd, Winnipeg, MB R3H 1A4 Credit Card (Enter Info below)

Name on Credit Card *

Do you require pick-up of your gift donation? If so, please include pick-up location, contact name and phone number below. *

Amount in ($) Dollars *

Card Type *

Credit Card Number *

Expiry Date *

CVC # *

Receipt Required for Cash Donation? *

Submit

Donations

Donation Form