Canvasback Missions, Inc.
940 Adams Street, Suite R
Benicia, CA  94510   USA
Phone: 800-793-7245     Fax: 707-747-1861

Yes! I want to participate in Canvasback's exciting capital campaign to acquire and outfit two new ships for medical mission service to needy Pacific islanders.

Your Name (please print): ___________________________________________________
Address: ________________________________________________________________
City: ________________________ St. __ Zip _____________ Country _______________
Phone: (day)___________________________  (eve) _____________________________
Fax: _____________________________ Email __________________________________

Membership Options:     (See Membership Info for details.)

__  I would like to join the Wellness 777 Club with my gift of $777 or more.
__  I would like to join the Fitness 500 Club with my gift of $500 or more.
__  I would like to be a Voting Member with my gift of $300 or more.
__  I would like to be a Crew Member with my gift of $____________

Note: According to IRS regulations, certain club gifts are not tax-deductible; therefore, the portion of your donation that represents the fair market value of those gifts is not tax-deductible.  If you would prefer not to receive those items, please let Canvasback know at the time you become a member. 

Payment Options:

__  My gift of $______________ is enclosed.

__  I would like to fulfill my pledge of $__________ in gifts paid:
            __ Monthly   __ Quarterly  __ Single Gift

__  Please charge $_______ to my credit card.  __ VISA   __ MC   __ AE   __ DISC

Card No.________________________________    Exp. Date ____/____

Name on Card (please print):____________________________________________

Remember, donations of autos, RV's, boats, stocks, real estate, wills, trusts, securities and materials can all be utilized by Canvasback toward the final push to return to the islands.

• Donate stock, or anything with built in capital gains, and you pay no tax on the capital gains.  You can deduct its full market value at the time of donation. 

• Make a tax-deductible donation of good condition used sedans, trucks or minivans for use as mission vehicles.

• Check out your company's matching gift programs; many will match as much as 100% of your gifts to Canvasback!