Street Reach Ministries of Ontario Inc. # 4 Partridge Road Timmins, Ontario P4N8R8 Phone (705) 268-6012 email rockman@persona.ca Donation Form Name___________________________________ Address_________________________________ City/Town_______________________________ Postal Code______________________________ Phone#_(705)-____________________________ Amount of Donation______$________________ Would you like to receive updates on our food bank operations? Yes____ No_____ Would you like to hold a food drive for our organization? Yes____ No_____ Would you like your donation to be anonymous Yes____ No_____ Direct deposits can also be made at our local bank branch. Canadian Imperial Bank of Commerce Pine & Third,PO Box 360,Timmins acct# 092 00492 010 53 02536 Att: William Jones 1