E-Transfer Form IG Wealth Management Walk for Alzheimer's

After submitting this form you will be sent an email with instructions on completing your e-transfer. Please check your spam/junk folder if you haven't received an email.

Question Title

* 1. Donation Amount

$25

$50

$100

$200

Other (please specify)

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* 2. Name of Walker / Team donation should be allocated to.
For example: Jane Smith or ABC Walkers

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* 3. Contact Details

First Name

Last Name

Address

Address Line 2 (or N/A)

City

Province

Postal Code

Email example@example.com

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* 4. Phone Number (please enter using format (000) 000-0000 )