Membership Form

SMILES FOUNDATION


Name: _________________________________________________________________
Address:________________________________________________________________ City:___________________________________________________________________

Province/Region: ____________ Postal Code: _________ Country: ____________

Phone Number: ____________________________

E-mail:____________________________________

Website: ______________________________________________________________

Cheque enclosed in the amount of: ________________ made payable to Smiles Foundation

Please send me additional information.

Please send me a video ($20)

Please contact me at the address above to discuss planned giving

I want to volunteer, please send me information

Thank you for supporting Smiles Foundation

As a member of Smiles Foundation, you will be entitled to:

  • A free subscription to our semi annual Newsletter to keep you up-to date on the changes your gifts are bringing.
  • Invitation to attend social events at special rate for members.
  • A certificate suitable for framing that may be displayed in your office.
  • An entry in our database of members. You can post your name and contact information (up to 200 characters). If you have a website, we can offer you a link.