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(a) I authorize Centraide to charge the above amount to my credit card on the 1st of each month.
(b) I understand that my pledge is open-ended but that I can modify my contribution or cancel this agreement at any time by communicating with Centraide 15 days before the next payment date.

Payment method:

3 numbers on back of card


Type of donation:     

Ex. A6A 6A6


1. Canada Revenue Agency requires the donor's personal address to appear on the charitable tax receipts issued by Centraide.
A tax receipt will be issued for every donation of $20 or more. Registration No.: 11884 2517 RR0001

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