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DONOR AGREEMENT FORM Northern Environmental Action Team (NEAT) Northern Environmental Action Team (NEAT) thanks you for your much-needed support of NEAT’s programs to targeting waste reduction, water and energy conservation, and environmental awareness. To keep a clear record of your donation, we ask that you complete this form. You will receive a taxdeductible receipt and we will keep you informed of NEAT’s programs and events.

I WOULD LIKE TO SUPPORT NEAT. PLEASE PUT MY NAME OR LOGO ON A ($20 additional set up fee for logos) $250 X ____ = $______

2’x2’ TILE (S).

Total Enclosed $_________

PLEASE MAKE CHEQUES TO: NORTHERN ENVIRONMENTAL ACTION TEAM or NEAT PLEASE PRINT CLEARLY

Donor’s Name (s) for Printing on the Tile (s) (Logo’s will need to be sent electronically to info@neat.ca)

1.______________________________________________ 2.______________________________________________ 3.______________________________________________

Name of Person or Company to be on the tax-deductible receipt________________________________ Address___________________________________City____________________Postal Code___________ Phone____________________________________ Email_______________________________________

________________________________________ NEAT’S AGREEMENT WITH EACH DONOR

NEAT agrees to put the rubber tire tile(s) at the North Peace Regional Airport to be used in their upgrade plans. NEAT will use the fundraising dollars for educational and awareness programs for residents of Northeast BC. In a situation where the program is not completed or, for some unforeseen circumstances, the program cannot proceed, I agree to allow NEAT to apply these funds for another worthy program within NEAT’s mandate. DATE OF DONATION__________________SIGNATURE OF DONOR______________________________________

PLEASE RETURN FORM TO:

10027 – 100 Street, Fort St. John, BC, V1J 3Y5

FOR OFFICE USE ONLY: OFFICE PERSONNEL__________________ DETAILS_____________________________________________________________________________________ TAX-RECEIPT ISSUED______________________________________ DATE ISSUED_________________________


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