Loyola High School
On-Line Donations
Donate with confidence. You're on a secure server!
If you have any questions, please contact Maria Carneiro
at carneirom@loyola.ca or 514-486-1101 x224.
Donor Information
* = required
First Name *     Initial
Last Name *
Affiliation *
Year of Graduation     (if applicable; 4 digits )
Address Line 1 *
Address Line 2  
City *
Province/State *
Postal/Zip Code *
Home Telephone *
Cell Phone  
E-Mail *
  I wish to remain anonymous.
* I would like this gift to be directed to:
$ Greatest Needs
$ Financial Aid
$ Endowment
$ Class Bursary Endowment (Reunion Giving)
$ Mothers-for-Others Bursary Endowment
$ Adopt-a-Student (full:$8,500 or half:$4,250)
$ Other (please specify)
Payment Information
I would like to contribute:
Total Donation Amount (Cdn$) *
Please debit my credit card *
Monthly         with payment/installments of   (Cdn$)
One-time Gift  
Credit Card Type *
Credit Card Number *
Expiration Date *   *
Name on Card *
Matching Gift
Please indicate whether your employer or your spouse's employer will match your gift.
  Yours | Spouse | Organization Name(s)
Yes, matching form will be sent later
Please email or mail your matching gift form to Maria Carneiro at carneirom@loyola.ca OR 7272 Sherbrooke St W, Montreal, QC H4B 1R2.

In Honour / Memory of
I would like this gift to be in Honour / Memory of:
      In Honour   In Memory
  Please send an acknowledgement of my gift to:
Special Instructions

Thank you for your support! A tax receipt will be sent to you by mail.

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