Online Donate Form

Looking to donate a different way?

Donate by phone (call your local Lung Association toll-free)

Donate by mail  Click to download this donation form and mail it to your provincial Lung Association.

Donate in person (Visit your local Lung Association)

I am donating as:




Personal Information

Ext.


Payment Information


/ (Month / Year)
As an added security measure, we ask that you enter the 4 digits on the front of your credit card, above the credit card number, called the CVV2/CCID. See sample on right.

You will be emailed an official Canadian tax receipt for income tax purposes.


Page Last Updated: 04/11/2016