Box 531, 91-B Dundas Street East, Napanee, ON K7R 1J1
(613) 354-0833 • Fax (613) 354-1154
peggy@landahospice.ca cindy@landahospice.ca
http://www.landahospice.ca

Please accept my GIFT to:

Hospice Lennox and Addington

H.L.A. Douglas Thompson children's Wish Fund

(please check one)

Amount:

Name:

Address:

City:

Province:

Postal Code:

Email:

Phone:

Business Name:

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Please make cheques payable to: Hospice Lennox and Addington
Charitable No. 89098 5591 RR0001  Donations are tax deductible and receipts supplied