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If you wish to make a donation to the Mira Foundation, you simply have to fill the form
below and send it back by mail or contact us by phone. You can also make a donation by
clicking on “Make a donation” at the home page of our website. You will then be redirected
to our secure form on which you can also make a donation.

                           Thank you for helping us better see the future !

Name :
Address :
City :
Province/State :                                   Postal code/Zip :
Tel. : (       )                                   Amount :
E-mail :

Cash               Check          Visa          Master Card            Amex

 Card no. :                                        Expiration date :
 Signature :

The Mira Foundation will issue an official income tax receipt for donations over 20,00 $.

   Check this box to receive an official income tax receipt.

Income tax registration no. : 11892 4232 RR0001
The Mira Foundation is incorporated as per la Loi sur les compagnies (non-profit), libro C-
1091 folio 117.

Headquarters                                           Quebec Office
Fondation Mira Inc.                                    Fondation Mira inc.
1820 rang Nord-Ouest                                   2700 Jean-Perrin, local 114
Sainte- Madeleine QC J0H 1S0                           Québec QC G2C 1S9
Tél. : (450) 795-3725                                  Tél. : (418) 845-6472
Téléc. : (450) 795-3789                                Téléc. : (418) 845-1000
E-mail :

                       «The relationship between man and dog is so natural
                     that even when a man is lost in his soul, he finds himself »
                                           Éric St-Pierre