We thank you in advance for selecting InnerVisions as a recipient for your donation. Donations go a long way towards helping us to do the fine work we do. We greatly appreciate your support! Would you like to help with fund raising? If so click here. Submitting Online When you submit online donations to InnerVisions Recovery Society, your information is stored using state-of-the-art security techniques. We also always use secure industry-standard encryption technology when transferring and receiving registration form-related data. Credit card transactions are securely handled by InnerVisions Recovery Society staff. We do not store any credit card information on the InnerVisions Recovery Society web site. Submitting By Mail To submit credit card and/or cheques by mail please print this form and complete as required and mail to: InnerVisions Recovery Society #1 - 11435 201A Street, Maple Ridge, B.C. Canada V2X 0Y3 Canada Questions If you would like to contact InnerVisions for more information on how to donate please call (604) 468-2032 Donor Information Fields marked with a red asterisk (*) must be completed. Mr Mrs Ms Miss Dr *First Name:   *Last Name: *Home Address: *City:   *Province/State: *Postal Code/Zip:   *Email: *Phone (h):   Phone (w): I would like to make a donation To the area of greatest need Current Campaign Other: Please specify - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - In memory of: Please specify In honour of: Please specify Occasion for gift: i.e. Birthday, Wedding, Anniversary, Appreciation of Your Doctor. Please mail acknowledgement of this gift to: i.e. Name, Full Mailing Address, Telephone, & Email. Contribution Gifts of $1000 or more will be recognized on our Donor Wall. Please accept my contribution of: $100 $250 $500 $1000 $1500 I prefer to contribute: Payment Method Visa Only *Card number: *Security code (back of card): *Expiry date: *Cardholder's name: Monthly Giving If you would like to become a Monthly Partner, please contact us at (604) 468-2032 or by email at callcentre@innervisionsrecovery.com. Lasting Contributions Please send me information about leaving a gift in my will to InnerVisions Recovery Society. Consent to the Collection, Use & Disclosure of My Personal Information I consent to InnerVisions Recovery Society collecting, using, processing, disclosing, acknowledging and reporting my personal information as required by law, in order to comply with all legal and regulatory requirements relating to my donation, and for the purpose of acknowledging my donation (unless I have indicated below that I wish to remain anonymous). I give InnerVisions Recovery permission to contact me regarding future campaigns and events (unless I have indicated below that I do not wish to be contacted in the future. I understand that InnerVisions Recovery respects the privacy of its donors and will not sell, trade or publish any personal information to other organizations. I wish to remain anonymous. I do not wish to be contacted in the future.