Donate Now – TeamBrokenEarth

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Dr. David Lacey Memorial Scholarship

Secure Donations

Thank you for your generous support of Team Broken Earth.

The Dr. David Lacey Memorial Scholarship has been established to provide annual funding for a MUN Medical student

to join a support mission. The student will have demonstrated

excellence in patient-centred and compassionate care.

Please provide the requested information so that we can process your donation.

Personal Information

If you would like to receive a tax receipt for your donation, please provide all of the requested information.

First Name

Last Name

Mailing Address

City

Country

State / Prov.

Zip/Postal Code

Contribution Amount

Please enter the amount you would like to contribute.

Frequency:

Contribution Amount:

CAD

Credit Card Information

Please type the cardholder name as it appears on the credit card.

Cardholder Name:

Credit Card #:

Security Code:

Card Type:

Expiry:

MM/YY

Team Broken Earth
PO Box 23004 RPO Churchill Sq.
St. John’s, NF
Canada A1B 4J9