PLEASE USE THIS FORM TO MAKE YOUR PERSONAL TAX DEDUCTIBLE DONATION TO

THE CTRF SCHOLARSHIP FUND

Enclosed is my donation of $______________ to the CTRF Scholarship Fund

Please check one of the following:

________ a)  I would like this donation to be used to support the scholarship awards during the coming year.

________ b)  I would like my donation to be added to a permanent fund from which the interest will be used to finance scholarships each year.  I hereby direct that the gift noted below (or any property substituted thereof) made to the Canadian Transportation Research Forum (CTRF) Scholarship Fund.  Registration No. 0791368-21 be held for a period of not less than ten (10) years.

Amount of Gift  $__________                                                    Date of Gift  _____________________

Name of Donor        ____________________________________________

Address    ___________________________________________________

                   ___________________________________________________
                                                                                                Postal Code

Signature of Donor   ___________________________________________

Please make your cheque payable to the CTRF Scholarship Fund and send your donation to:

Canadian Transportation Research Forum
P.O. Box 23033
Woodstock, ON   N4T 1R9

An official receipt for Income Tax purposes will be issued.

FOR OFFICE USE ONLY

Date Received ____________________                        Official Receipt #