Professional Documents
Culture Documents
Donationform
Donationform
DonationData
I/WewishtosupportthefollowingBoardapprovedministryofBCMInternational(Canada)Inc.
Theministryof______________________________________________________________
Pleasechooseoneofthedonationformsincluded.
OneTimeDonation
NameandAddressofDonor________________________________________________________________________
______________________________________________________________________________________________
TotalDonationAmount__________
___cheque(payabletoBCMInternationalCanadaInc)
___cash(enclosed)
__CreditCard:CardType________________CardNumber________________________Exp.Date|__________
Signature________________________________________
PreAuthorizedDonation
I/WeherebyauthorizeBCMInternational(Canada)Inc.todebitmy/ouraccountonthe
(pleasecircleone)1st15thor30thofeachmonthuntilfurthernotice.
Intheamountof$______
Tobegininthemonth____________
Designatedtotheministryof______________________________________
My/OurName________________________________
Address_____________________________________
City________________________________________Prov.______________P.C.___________________
PhoneNumber(______)______________________________
BankName_________________________________________
PleaseattachaVOIDchequetothisformandsignbelow
(Twosignaturesarerequiredforjointaccounts)
Signature___________________________________________
Signature___________________________________________
Imayrevokemyauthorizationatanytime,subjecttoprovidingnoticeof30days.Oobtainasamplecancellationform,orfor
informationonmyrighttocancelaPADAgreement(PreauthorizedDebitAgreement),Imaycontactmyfinancialinstitution
orvisitwww.cdnpay.ca
Ihavecertainrecourserightsifanydebitdoesnotcomplywiththisagreement.Forexample,Ihavetherighttoreceive
reimbursementforanydebitthatisnotauthorizedorisnotconsistentwiththisPADAgreement.Toobtainmoreinformation
onmyrecourserights,Imaycontactmyfinancialinstitutionorvisitwww.cdnpay.ca.
Pleasereturncompletedformtomissionrepresentativeorviapostto:
BCMInternational(Canada)Inc.
685MainStreetEast,HamiltonONL8M1K4
Phone9055499810TollFree18772729262Fax9055497664Email:mission@bcmintl.ca
Giftsareacknowledgedwhenreceivedandanofficialreceiptisissued.