--------------------------------------------------------------------------

"Touch the Sky" Order Form

--------------------------------------------------------------------------

Candlelighters Childhood Cancer Foundation Canada

55 Eglinton Avenue East, Suite 401, Toronto, Ontario M4P 1G8

Phone: (416)489-6440 or 1-800-363-1062
Fax: (416) 489-9812
Internet: http://www.candlelighters.ca
Email: [email protected]

Please Check one...

Yes! I would like to order a Touch the Sky kit for a special introductory price of $35.00

Yes! I would like to make a tax-deductible contribution to Candlelighters Canada (earmarked Touch the Sky Project). This will help make the kits available at no cost to families whose children have cancer.

Please fill in the blanks below...

Name:

Address:

2nd line:

Postal Code:

Phone #:

Visa/Mastercard number:

Expiry date:

Cheque or money order enclosed


--------------------------------------------------------------------------

Candlelighters HomeClick here to go back to our main page
Email Candlelighters StaffComments, and suggestions may be sent to [email protected]

--------------------------------------------------------------------------