YOUTH FOR CHRIST Canada Box 93008, #135 19705 Fraser Hwy.

., Langley, BC V3A 8H2 Phone: 604-595-2498; 1-800-899-9322 info@yfccanada.org I would like to support ALYSSA LIVINGSTONE serving with Youth for Christ Canada:

Name: _____________________Address:________________________________________ City/Province:___________________Postal Code: _____________ Phone:______________ With a one-time gift of: $________ With a monthly gift of: $________ Cheque(s) Make cheques payable to Youth for Christ, Canada (see address above, please attach this form or a separate note, which says for support of Alyssa Livingstone) Pre-authorized Debit - enclose a void cheque Indicate monthly transfer date 1st or 16th Starting month:_________________Signature:____________________ Credit Card Visa or Mastercard Card Holders Name:____________________ Card Number:____________________ Expiry Date:_______ Indicate monthly transfer date 1st or 15th Starting month:_________________ Signature:____________________

Online Donation 1. CLICK http://yfccanada.org/ 2. SELECT: "Donate" in the Menue 3. SELECT: "Support a National Staff" in drop-down menu 4. ENTER: your personal data 5. SELECT: "Global Engagement" in drop-down menu in section: "Contribution Designation" 6. ENTER: "Alyssa Livingstone" into the section "Contribution Comments" (VERY IMPORTANT!)
I may revoke my authorization at any time, subject to providing notice within 30 days. To obtain a sample cancellation form, or for more information on my right to cancel a PAD Agreement, I may contact my financial institution or visit www.cdnpay.ca. I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial institution or visit www.cdnpay.ca. All funds received are receiptable for income tax purposes.

We have been advised by Canada Revenue to remind partners to use a separate piece of paper (such as this form) to designate support. Please do not write a name of an individual on a cheque. - Thank you!