Box 4751, Regina, Saskchewan S4P 3Y4

Autism Resource Centre

“To achieve a meaningful and independent life for individuals with Autism Spectrum Disorder through education, awareness and programming.”

Donation Form & Autism Awareness Order Form

I would like to support the work of the Autism Resource Centre by making a donation by credit card (click on the Donate Now button) or cheque (payable to: Autism Resource Centre) Pleased print form and mail.

Name:

___________________________________________
Address:
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City:
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Province:
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Postal Code:
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Phone:
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Email:
___________________________________________

Name, Address & Postal Code

Special Donations (Optional):
I wish to make this donation . . .

Cheque

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Total: Donation:

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In Memory of

In Honour of

On the Occasion of

Sponsor Softball Player

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