Ontario Archaeological Society

Last Name

First Name

Middle Name/Initial

Title

*Email

Afflilation/Organization

Department

*Street Address

*City/Town

*Province/State

*Country

*Postal/Zip Code

A1A 1A1

Phone Number

111-111-1111

*OA Subscriber

Yes

No

*Please Indicate if you are donating to the OAS generally, to a specific Fund, or for another intent

OAS Symposium

The Charles Garrad Avocational Archaeological Collections Fund

Valerie Sonstenes Student Research Fund

OAS (unspecified)

Awards Fund

Futures Fund

Ontario Archaeology Publication Fund

Peggi Armstrong Award for Public Archaeology

For a Chapter(s)

If donating to a specific Chapter(s), please specify which Chapter(s)

*Is this Donation in your name, in memory of, or for someone else?

In My Name

In Memory of

On Behalf of

If in Memory of or on behalf of, please indicate who here

*May we acknowledge the named donor publically, or should this remain anonymous?

Acknowledge Donor

Remain Anonymous

*Amount ($CAD)

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