2023 Sponsorship Registration

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7th Annual Talk, Stroll, and Roll Walkathon Fundraiser for Aphasia

Helping those who know more than they can say

Email *

First name *

Last name *

Company name *

Who would you like the tax receipt to be made out to? * Please note that the tax receipt name must match who actually made the payment, be it an individual or a corporation.
*

My name

Company name

Other:

Full address (including street address, city, province, and postal code)
*Please note: This should reflect the response above. *

Phone number

Sponsorship level ($CAD) *

Bronze: $150

Silver: $500

Gold: $1500

Platinum: $3000

Other:

Note RE: Payments:

* Please note that using our online platform cuts down on our administrative time and is the easiest, most efficient way to donate!

** If donating online, please note that the "tip" amount is optional (and automatically populated to $5).

You may change this tip to as little or as much as you like. This tip amount goes to Kambeo, the online platform, NOT to the aphasia programs.

Method of payment *

E-transfer (sent to info@h-pcap.com)

Cheque (contact us for our address)

Online (via https://app.kambeo.io/event/7thtalkstrollroll)*

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