CCA - Donations and Trusts: Individual Cash Donations



	Canadian BMX Championships Canadian Cyclo Cross Championships Canadian MTB Championships Canadian Para-Cycling Championships Canadian Road Championships Canadian Track Championships

	Canadian Team competing at: MTB 31/08-04/09/2011 www.bikepark.ch

	PARA-CYCLING Sept 8th to 11th 2011 Official Website

	BMX Copenhagen - Denmark 28-31.07.2011 Official Website

	ROAD 19-25/09/2011 www.copenhagen2011.dk

	CYCLO-CROSS Koksijde - Belgium 28-29 January 2012 www.koksijde2012.be

	TRACK Melbourne - Australia 04-08 April 2012 Website

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INFINIT NUTRITION
Custom-Blended Nutrition Solutions
for Cyclists

INDIVIDUAL DONATION FORM

Name:__________________________________

Address:____________________________________________________________

Postal Code:___________________    Country:___________________

Donation Amount:_____________________

Donation Levels:
Supporter: $0 to $999   |   Friend: $1,000 to $2,499   |   Patron: $2,500 and over

METHOD OF PAYMENT

Cheque/Money Order:
Please make cheque/money order payable to Canadian Cycling Association (send via mail with completed form)

___ Visa   ___ Mastercard   ___ American express

Card #____________________________

Expiry Date:______________

Name on card: ____________________________

Signature: ____________________________ (mail in only)

Thank you for your support - it is greatly appreciated! A tax receipt will be mailed to you at the address indicated above.

Click here to print form.

203 - 2197 Riverside Drive, Ottawa, Ontario, K1H 7X3