Sponsorship Payment

Please provide your contact and payment information below. Your contact information is required to generate an electronic tax receipt which will be sent to the email address that you provide. If you would like to give an extra gift along with your sponsorship payment, please select the Sponsorship & Extra Gift box & enter the sponsorship amount plus the gift. Let us know in the comment field what the extra payment is for such as birthday, Easter, special money for the family, etc.

Donation Amount

$33
MonthlySponsorship per month
$396
AnnualSponsorship for the year
Sponsorship & Extra Gift

Did you know that by covering the processing fee, Chalice will be able to help more people?

I'd like to cover the fee so 100% of my donation goes to the nonprofit ( %ProcessingFee% ).

Donor Information

Name

First Name

Last Name

Organization Name

Contact Information

Address 1

Address 2 (Optional)

Country

State

City

Zip Code

Phone Number (Optional)

Email Address

I allow Chalice to contact me by email

I allow Chalice to contact me by mail

Comments

If there are other gifts included in this sponsorship payment, please let us know in this comment field so that we may direct your gift according to your wishes?

Payment Information

Card Holder Name

Card Number

Expiry MM

Expiry YY

CVV (?)

Bank Name

Bank ID

Cheque Number

Transit Number

Account Number