Monthly Donations

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Monthly Donations

To set up monthly donations, you can download the printable pdf form here and mail that to our office. Or, fill in the online form below:

My Monthly Donation

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
I (we) authorize Christian Service Centers of Canada Inc to process a monthly debit in the amount of $
from my (our) account* on the 15th of each month beginning on
*A void cheque from the bank account will need to be submitted separately from this form.
This donation is made on behalf of
- An Individual
- A Business or Charity
Statement of Acknowledgement*
- I Agree
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,obtain a sample concellation form or for more information on my right to cancel this PAD agreement I may contact my financial institution or visit www.cdnpay.ca I may revoke my authorization at any time, subject to providing notice of at least seven business days, by contacting CSC by phone at 519-690-1615.
Phone
This field is for validation purposes and should be left unchanged.

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Array ( [0] => Oneida Central P.S. [1] => Huron Centennial P.S. [2] => Hullett Central P.S. [3] => Lansdowne P.S. [4] => London Road P.S. [5] => King George VI P.S. [6] => Plympton-Wyoming P.S. (Wed) [7] => Brigden P.S. [8] => Delhi P.S. [9] => Lakewood P.S. [10] => Westfield P.S. [11] => South Ridge P.S. [12] => Northdale P.S. (Woodstock) [13] => Burford District P.S. [14] => Oakland-Scotland P.S. [15] => Tavistock P.S. [16] => Select Club [17] => West Lynn P.S. [18] => Centennial Central P.S. [19] => Annandale P.S. [20] => Eagle Heights P.S. [21] => River Heights P.S. (Dorchester) [22] => Northdale P.S. (Dorchester) [23] => Emmanuel Christian Church [24] => Royal Roads P.S. [25] => Courtland P.S. [26] => Algonquin P.S. [27] => Jarvis P.S. [28] => Centennial Central P.S. [29] => Plympton-Wyoming P.S. (Wed) [30] => Lynndale Heights P.S. [31] => Grand Bend P.S. [32] => Southside P.S. [33] => West Nissouri P.S. [34] => River Heights P.S. (Caledonia) [35] => Caledonia Centennial P.S. [36] => Glen Cairn P.S. [37] => Byron Northview P.S. [38] => Victor Lauriston P. S. [39] => J. L. Mitchener P.S. [40] => Test Club [41] => Waterford P.S. [42] => Innerkip Central P.S. [43] => Houghton P.S. [44] => Teeterville P.S. [45] => Port Rowan P.S. [46] => Bloomsburg P.S. [47] => Oakland-Scotland P.S. [48] => East Williams Memorial P.S. [49] => Exeter Elementary P.S. [50] => Fairmont P.S. [51] => Arthur Ford P.S. [52] => Wilberforce P.S. [53] => Chesley District Community School [54] => Northridge P.S. [55] => Glen Morris Central P.S. (Afternoon) [56] => Tilbury Area P.S. [57] => Merlin Area P.S. [58] => Byron Northview P.S. [59] => Lambeth P.S. [60] => St. George-German P.S. [61] => King George P.S. [62] => Winchester Street P.S. [63] => Cobblestone P.S [64] => Glen Morris Central P.S. (Morning) [65] => Select Club )