CIPH FUNDRAISER IN SUPPORT OF HABITAT FOR HUMANITY CANADA 2012/2013 PLEDGE FORM The committees fundraising goal for cash and products for the years 2012 and 2013 is set at $2.75 million. Our goal is to provide 250 packages of product certificates for 2012 and 250 packages of product certificates for 2013. Companies donating more than $25,000 ($5,000 must be in the form of a cash donation) will be recognized as MAJOR DONORS for the 2012 and 2013 campaign. Habitat builds simple, basic homes; therefore, they cannot accept donations of luxury products. Please specify below if your product donation can be used in a hydronic heating application. □ We will provide gift certificates for products. □ Hydronic □ Plumbing Product Name/Number: ___________________________________________________________________________________ Retail Value: ______________________________________________________________________________________________ Quantity of gift certificates to be donated for 2012: __________________________________________________________ Quantity of gift certificates to be donated for 2013: __________________________________________________________ Please provide redemption instructions e.g. Can the Habitat representatives redeem the certificates at a CIPH wholesaler? OR Should the Habitat representatives redeem the certificates directly with your company? Please consider your anticipated shipping costs if you prefer the second option, as affiliates are located all across Canada. CIPH Staff will prepare your company’s certificates for your review and approval. □ We will donate cash. $______________ for 2012 $______________ for 2013 Your 2012 donation cheque should be payable to: CIPH in trust for Habitat for Humanity Canada Foundation and mailed to: 295 The West Mall, Suite 330, Toronto, ON M9C 4Z4. CIPH will send a “pledge reminder” to you for your 2013 donation. □ We have product to donate through the Habitat for Humanity ReStore – Please call me. Attach your business card and fax to CIPH Fax completed form to: 416-695-0450 THANK YOU!
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