2019 Donation Form

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Thank you for your support

Please provide your contact and payment information. The contact information is required to generate a tax receipt. The electronic tax receipt will be sent to the email address that you provide.

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* First Name:
* Last Name:

Contact Information


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* Address:

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

Allow President's Choice Children's Charity to contact me by email.
I give President's Choice Children's Charity permission to contact me by mail (post).

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Payment Information

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* * Donation Amount:
* Processing Date:
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* Credit Card Type:
* Credit Card Number:
* Card Security Number:	Where is my Card Security Number?
* Cardholder's Name:
* Credit Card Expiration:



* Bank Name:
* Bank ID:
* Cheque Number:
* Transit number:
* Account Number:

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PLEASE DONATE

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