Town/City Zip/Postal Code .
Province/State Country _______________________________.
Telephone (............)) Fax (............)) .
E-mail address (print very clearly) @ .
Tax receiptable donation amount: $1000_____500_____200______100______Other_______
Canadian cheques are payable to "Friends of the Mennonite Centre
in Ukraine" or "FOMCU",
and should be mailed to the address below
George Dyck, Treasurer,
3675 North Service Road
Beamsville, Ontario, Canada
(detach and retain for your own records)
My record of donation:
Date sent Cheque Nbr .
Tax receipts will be issued in time for tax filing
Thank you for your support for the Mennonite Centre in
To see how we stretch you dollars, please see our
latest Newsletter - Page 1 Page 2
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