Donor Name(s)

Street Address

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",
Checks from American donors should be made out to "MFC-FOMCU",  and all
 should be mailed to the address below (making sure you have appropriate postage)

                                                                                                                                      .
(detach and retain for your own records)

George Dyck, Treasurer,
3675 North Service Road
Beamsville, Ontario, Canada
L0R 1B1

My record of donation:

Amount: $

Date sent                                               Cheque Nbr                             .

Tax receipts will be issued in time for tax filing

Thank you for your support for the Mennonite Centre in Ukraine!

New and easy - If you would like to make a contribution online using your credit card, please follow this link
to "Friends of the Mennonnite Centre in Ukraine"