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            In Memoriam!
Don In Memoriam
Sitemap map/plan!
Print Version print/imprimer!
e-mail/formulaire! Mailform

Guestbook book/livre!
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      SsS (de JLS-1954)

An idea that is developed and put into action is more important than an idea that exists only as an idea.

- Buddha

© Copyright 2006 - JLS-1954 - Citations PhP Simple

Faites un don - Recherchez un organisme de bienfaisance

You are here :   Mailform



You can send us a donation via this form ...

1. Enter the information requested on the form below.

2. We will send a card to the family to inform them of your gift (donation amount undisclosed).

3. An employee of Dystonie-Quebec will call you tomorrow (or next business day)
to finalize your donation. You can also use the services of CanadaHelps to send donations,
you will find the link at the bottom of this page, BUT please first send us this form by clicking on the button Send .

Repeat this number

Name of deceased :

Name of donater :

Address :

City :

Postal Code :

Telephone (xxx) xxx-xxxx :

Sender e-mail :

Donation $ :


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