Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Who's donating today? *Donating as an individualDonating on behalf of a corporation (no tax receipt provided)Donating on behalf of a Lions club (no tax receipt provided)What type of gift would you like to give? *One-TimeMonthlyIn HonourIn MemoryDog Guide ScholarshipThe Difference CampaignPuppy Pal ProgramMy gift to The Difference Campaign is *One-TimeMonthlyChoose your gift amount *$25$75$150$250OtherChoose your gift amount *$100$500$1000$2500OtherChoose your gift amount *$25$75$150OtherGift Amount *$10,000Custom Amount *I would like to honour *I would like to donate in memory of *Choose your team to sponsor *$5,000 Novice Scholarship$7,500 Intermediate Scholarship$10,000 Advanced Scholarship$15,000 Expert Scholarship$35,000 Full ScholarshipWhere can we designate your gift? *The area of your greatest needAutism AssistanceCanine VisionDiabetes AlertHearingPuppy ProgramSeizure ResponseServiceFacility SupportCompany / Organization InformationEnter your company or Lions Club information below.Company / Organization Name *Company / Organization Address *Address Line 1City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonAlaskaAlabamaArkansasAmerican SamoaArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaGuamHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVirgin IslandsVermontWashingtonWisconsinWest VirginiaWyomingProvince / StatePostal Code / Zip Code--- Select country ---CanadaUnited States of AmericaCountryYour InformationName *FirstLastEmail *Phone *CommentsLeave a comment Billing InformationAddress *Address Line 1City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonAlaskaAlabamaArkansasAmerican SamoaArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaGuamHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVirgin IslandsVermontWashingtonWisconsinWest VirginiaWyomingProvince / StatePostal Code / Zip Code--- Select country ---CanadaUnited States of AmericaCountryPayment InformationCredit Card *E-CardSend an e-Card with this donationE-Card Recipient's Email *Choose E-Card Type *GeneralSympathyAnniversaryCongratulationsHappy BirthdayMother's DaySeason's GreetingsThank YouValentine's Day E-Card Preview Message to include in E-CardTotal Donation Amount$0.00Anonymous DonationMake this donation anonymousYour donation will remain anonymous and your name will not be printed in the annual reportDonation MatchingMy company matches donationsOur team will contact you to process any donations matched by your company or organization.Submit Donation
