In Honour of Norma "*" indicates required fields First Name* Last Name* Business / Organization Name (if applicable) Email Address* Phone NumberMailing Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Recognition* Yes, it's ok to publish my name as a contributor No, do not publish my name Newsletter Opt-in Yes, add me to your mailing list Donation Amount $ 25.00 CAD $ 50.00 CAD $ 100.00 CAD $ 500.00 CAD Custom Amount Custom Donation Amount ** Minden Pride is not a charitable organization so we cannot issue tax receipts for your contributions **Total Donation Credit Card Information* Cardholder Name Card Details CommentsThis field is for validation purposes and should be left unchanged.
