YMCA Quebec

Donate now and change someone’s life forever!

Your donation will change lives. It will make all the difference to a child who is left on their own after school, a teen who is having serious problems at home, a family who can’t afford activities for their kids, or an adult with a sedentary lifestyle, who lives alone and sometimes doesn’t see anyone all week.

* Denotes required information.

Donation Amount PCI

This site is secure

$500

$250

$100

Make giving easier with monthly gifts! The most effective way to make a difference.

Make this my monthly donation

This is a

* denotes required information

Personal donation
Donation on behalf of an organization

Title:
* First Name:
* Last Name:

* Organization:

Contact Information


	Home Work

Enter address manually
Job Title:
* Address:

* City/Town:
* Country:
* * * Province/State:
* Postal/Zip Code:
Phone Number:	( ) Ext.
Cell Phone Number:	( )
* Email Address:

Yes, I would like to receive donation receipts and occasional communications from the YMCAs of Québec.

* Language Preference

* How did you hear about the YMCA? Select one:

If you selected "Other," please specify how you heard about the YMCA:

* Please designate my gift to one of the following sectors or centres:

Please choose your local YMCA Centre

Is your gift anonymous?

I wish my gift to be recognized under this name:

If this donation is in memory/in honour of someone, please indicate the name/reason below:

My company has a matching gift program. Company name:

Payment Information

Pay using Credit Card
Card Security Number is not supported in data entry. To process a credit card payment, you need to disable Card Security from the Electronic Payment page in the Configuration tab.
Payment Method:	One Time Payment Credit Card Monthly Payments Credit Card
* * Donation Amount:	Description of suggested amount 1 Description of suggested amount 2 Description of suggested amount 3 Description of suggested monthly amount 1 Description of suggested monthly amount 2 Description of suggested monthly amount 3 Other Other
* Start Date:
	installments
Pay using PayPal
* Credit Card Type:
* Credit Card Number:
* Card Security Number:	Where is my Card Security Number?
* Cardholder's Name:
* Credit Card Expiration:
Card Valid From
Issue Number
* Bank Name:
* Bank ID:
* Cheque Number:
* Transit number:
* Account Number: