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Power of Attorney
DONOR INFORMATION: The donor is the individual giving authority to a trusted person (called the attorney) to act on their behalf, when the donor is not capable of making such decisions
Donor First Name
*
*
Donor Last Name
*
*
Email
*
*
*
Phone Number
*
*
Existing Client
Existing Client
No
Existing Client
Yes
For existing clients, please enter the same First and Last Name used in your previous file with us
Donor Address
Address Line 1
*
Address Line 2
*
Town/City
*
Province
AB
BC
MB
NB
NL
NS
ON
PE
QC
SK
YT
NU
NT
Other
Postal Code
*
Country
*
Employment
Employment Status
*
Unemployed
Employed
Retired
Occupation
*
Employer Name
*
Employer Address
*
Business Phone
*
Hidden
*
*
*
