Donation form

Thank you for choosing to give to uOttawa.

We sincerely thank you for helping us in our efforts to provide our students with exceptional learning opportunities, generate research breakthroughs, remain competitive globally and offer a unique bilingual educational and cultural environment.

All fields in this form are mandatory unless indicated otherwise.

 

Donation Information
Amount:	$ 15 $ 15.00 $ 25 $ 25.00 $ 50 $ 50.00 $ 100 $ 100.00 $ 125 $ 125.00 $ 225 $ 225.00 $ 425 $ 425.00 $ 500 $ 500.00 $ 1,000 $ 1,000.00 $ 2,500 $ 2,500.00 $ 5,000 $ 5,000.00 Other $     *
Designation:	University of Ottawa Refugee Hub Fund
Additional Information
Type of gift	One-time gift Recurring gift
Frequency:	Weekly Monthly Quarterly Annually On:   Sunday Monday Tuesday Wednesday Thursday Friday Saturday Starting:    Ending:   Ending:
Corporate:	This donation is on behalf of a company.
Anonymous:	I prefer to make this donation anonymously.
Your relationship with uOttawa:	Alumnus / Student Employee / Professor /Retiree Other	*
Billing Information
Title:	Docteur Docteure Dr. Madame Maître Monsieur Mr. Mrs. Ms. Professeur Professeure Professor
First name:		*
Last name:		*
Country:	Canada USA Afghanistan Albania Algeria Andorra Antigua and Barbuda Argentina Armenia Australia Austria Bahamas Bahrain Bangladesh Barbados Belgium Benin Bermuda Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroun Chile Colombia Congo Costa Rica Croatia Cuba Cyprus Czech Republic Côte d'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Germany Ghana Gibraltar Greece Grenada Guadeloupe Guatemala Guyana Haïti Honduras Hong Kong SAR, China Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Maroc Martinique Mauritanie Mauritius Mexico Montserrat Mozambique Namibia Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Panama Papua New Guinea Paraguay People's Republic of China Peru Philippines Poland Polynésie française Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Lucia Saudi Arabia Sénégal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Somalia South Africa Spain Sri Lanka Sudan Suisse Swaziland Sweden Syria Taiwan Tanzania Thailand Togo Trinidad and Tobago Tunisie Turkey Uganda Ukraine United Arab Emirates United Kingdom Uruguay Vanuatu Venezuela Vietnam Virgin Islands Yemen Zambia Zimbabwe	*
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Province:	<Please Select> ON QC AB BC MB NB NL NT NS NU PE SK YT AL AK AS AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY MP NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA VI WV WI WY AA AE AP CZ FM MH PW --	*
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Phone:		*
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Payment Information
Cardholder's Name:		*
Credit Card Number:		*
Card Type:	MasterCard Visa	*
Card Expiry:	01 02 03 04 05 06 07 08 09 10 11 12  / 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034	*
Card Security Code:		*
Other information
	My company will match my gift.
Company		*
Tribute information
Type	In memory of In Honour of	*
Name:		*
First name
Last name		*
	Send a letter on my behalf to	*

*Notice of collection of personal information *

Personal information contained on this form is collected under the authority of the 1965 University of Ottawa Act and in accordance with the Freedom of Information and Protection of Privacy Act. It will be used for purposes consistent with processing your donation, issuing a receipt for your donation, updating your personal information and providing you with information about alumni programs, events, activities, products and services provided by the University and affinity partners, news, fundraising campaigns, and donation and volunteering opportunities. If you have questions about the collection, use and disclosure of your personal information in this notice, contact the Alumni Relations Office at 613-562-5857 or 1-800-465-1888, or email alumni@uOttawa.ca.