MSMF Donation Form
Please COMPLETE this form. PRINT it and MAIL with your donation – Cheque or Credit Card Info. to: MSMF, 23 Mary Drive, Gloucester, ON, K1V 1G9, Canada

ELIMINATE AVOIDABLE BLINDNESS
  Donate for Cataract Surgeries - 50$ per eye (No. of eyes) Amount: $
  Donate for Eye Camps - $2000 per camp:
(Minimum 50 Cataract Surgeries with IOLs)		 (No. of camps) Amount: $
  Donation to the Hospital:      $  
       
 

Educate Rural Poor Children

    
Midday Meals for all Students - $350 per month:
$
  
One Year Education Expenses - $100 per student:
$
  
Students’ Uniforms - $40:
$
  
Donation to the School:
$
  
     
Date: Total Donation:
$
  
     
Donor’s Name:  
Address:
Postal Code:  
Phone Number:   
Email:  
Donation Type Credit Card Cheque  
 
Print Print | Print Close