Native Orchid Conservation Inc.
Donation Form

Yes! I wish to donate to help save endangered plants and habitat;  enclosed is my donation of

[ ] $25.00[ ] $50.00[ ] $100.00[ ] $250.00 [ ] $500.00or   ______________


This donation is for:   [ ] General Funds     [ ] Brokenhead Boardwalk Project


Name:
________________________________________________________________
Address:
________________________________________________________________
________________________________________________________________


Special Instructions  (for "in memory of", etc):
________________________________________________________________
________________________________________________________________


A tax-receipt will be issued in February, next;  our Tax# is  86816 7198 RR0001.

Make cheque payable to  Native Orchid Conservation Inc  and mail it to:
Florence McCoy, NOCI Membership Chair
Box 28A, RR 2, Stn Main , Winnipeg R3C 2E6