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Parent of Old Boy
Friend of Selwyn House
Year of Graduation
(4 digits, if applicable)
Please indicate how you would like your name(s) to be recognized in our Donor Listings
I wish for my name to remain anonymous
Credit Card Information
I wish to pledge/contribute:
Please debit my credit card
with payment/installments of
Please keep my credit card details on file for any installment payments
Credit Card Type
Credit Card Number
Name on Card
Child's Full Name & Grade for Student Account
(if billed to Student Account)
I would like this gift to be directed to:
Campaign for Selwyn House School
(SHS AREA OF GREATEST NEED)
General Endowment Fund
Old Boys' Endowment Fund
The Hannaford/Doherty Mental Health & Wellness Fund
William Mitchell Endowment Fund
Conrad H. Harrington Endowment Fund
Nancy Pitfield Endowment Fund
John R. McConnell '65 Endowment Fund
David Pitblado '78 Endowment Fund
Gaelan O’Donnell '83 Endowment Fund
Colin No '97 Memorial Fund
Aditya Pathak 2005 Memorial Fund
Pledge Payments (If you have an existing pledge, payments can be made here.
Golf Tournament Donation
: It is important to maintain our Annual Giving, which supports special needs and program enhancements at the school. "One gift, two targets". We will designate 80% of your donation to the chosen Endowment Fund and 20% to Annual Giving unless you specify otherwise in the special instructions box below.
I would like more information about leaving a gift to Selwyn House School in my will.
Please indicate whether your employer or your spouse's employer will match your gift.
, matching form will be sent later
, matching not available
Please fax your form to James McMillan at 514-931-7152 or mail to him in care of the Advancement Office, Selwyn House School, 95 ch. Cote St. Antoine, Westmount, QC H3Y 2H8
In Honour / Memory of
I would like this gift to be in Honour / Memory of:
Please send an acknowledgement of my gift to:
Any special instructions we should know?
Thank You! Your receipt will be emailed to the above address.
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