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Canadian League Against Epilepsy


Help Us Reach Our Goal!

Donation goal

4%
Goal:
$2,500.00
Collected:
$100.00
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Donation

* Mandatory fields
 

Contact data

*First name
*Last name
Profession
Institution or Organization
*Complete Mailing Address
*E-Mail
*Alternate E-Mail Address
Phone
Are you a CLAE Member?
*Mailing Address
This is required for tax receipt purposes.
 

Donation

*Amount ($CAD)
I am donating in support of...[Name of individual]
For a list of Fun Run/Walk participants and
teams, please refer to the list
Comment
*Are you donating in support of the CLAE Fun Run
*I would like my donation shared on CLAE's donor page:
 

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