Sponsor InformationSponsor Name* First Last Mailing Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact PersonPhone*Contact Email* Social Media HandleSocial Media Channels Facebook Twitter Instagram Sponsorship LevelPlease Select OneVirtuoso ($25,000)Maestro ($10,000)Concertmaster ($5,000)Ensemble ($2,500)Soloist ($1,000)Encore Club (5-Year Commitment)PaymentPay by:Credit CardChequePlease contact meProcessing Fees Price: $ 0.00 CAD Total $ 0.00 CAD Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Pay by cheque: John Cameron Changing Lives Foundation Mailing address: John Cameron Changing Lives Foundation 11430 160 Street Edmonton, AB T5M 3Y7 Please issue a tax receipt Registered Charitable Number: 84866 6608 RR0001
