Sunshine Coach Renfrew Ontario
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Featured Sponsor
Dagenais Construction Window and Door
Friends of the Disabled Reach For The Rainbow Radiothon in support of Sunshine Coach Service
To make a pledge to the Reach For The Rainbow Telethon in support of Sunshine Coach Service please complete and submit the form below.

Your pledge will be treated just like a phone pledge in that it will count for any blitz if the date/time stamp of your submission falls within the hourly three-minute blitz time frame.  Pledges of $100.00 or more will entitle you to entry into our special Angel Prize Draw.  You may make your pledge at any time in the days leading up to the Telethon as well as on the day of the event. 
Pledge Amount*: (do not include $ sign) (enter the amount of your pledge here)
Organization / Individual Name*: (enter the name of your business, service club or other organization if applicable or if an Individual - Your first and last Names)
Address*: (enter your Street Address here)
City*: (enter your City name here)
Province*: (enter your Province here)
Postal Code: (enter your Postal Code here)
Telephone: (enter your Telephone Number here)
Cell Phone: (enter your Cell Phone Number here)
Fax Number: (enter your Fax Number here)
EMail Address*: (enter your E-Mail Address here)
Treat as Anonymous: (Check this box if you would like your pledge to be treated as an anonymous donation)
Challenge: (Check this box if you would like to issue a challenge to friends or colleagues to meet or beat your pledge.  Please provide details in the box provided)
Challenge Details: (enter the details of the challenge you are issuing here)
 
Payment Options:
You may honour your pledge:
1. by dropping your cheque off at the Sunshine Coach Offices between the hours of Noon & 5 pm on the event day;
2. by dropping your cheque off at the Sunshine Coach Offices at 850 O'Brien Road, Unit #2, Renfrew Monday to Friday 730 a.m. to 4:00 p.m.;
3. at any of the Banks in Renfrew; or
4. mailing your cheque to Sunshine Coach Service, 850 O'Brien Road, Unit #2, Renfrew, ON  K7V 0B4

Please make your cheque payable to Friends of the Disabled (Renfrew) Inc. 
Note:  * denotes items that are required. (Once you have entered all information applicable to your pledge, click on the Submit Pledge button to send it to us.  You will receive a confirmation e-mail message from telethon@sunshinecoach.ca.  If you change your mind and do not want to send the pledge or wish to start over entering your pledge information, then click on the Cancel button.)