Donation Form

CCPA Ontario Solutions Fund

Please specify in the comments section below, if your donation is in memory or in honour of a special person in your life. If you would like us to notify someone about this donation, please provide us with their name(s), full address and who this donation is from.

* Required Fields

Donation Information

Amount

$50

$250

$500

Other

Type of Donation

One Time Donation
Recurring Donation

Frequency

Contact Information
* First Name
* Last Name
* Address
Address 2
* City
* Province
* Postal Code
* Home Phone
Cell Phone
Email
Comments

Credit Card Information
* Card Holder Name

* Card Account Number
Expiration Date
* Security Code The 3 or 4 digit Security Code (CVV2) can be found on the back of your credit card. For American Express, the Security Code (CID) can be found on the front of the card.

Billing Address
Same As Above
* Billing Address
* Billing City
* Billing Province
* Billing Postal Code

Terms/Conditions
By clicking the "Submit Payment" button, you authorize us to charge the account provided for the total amount specified.

Privacy Policy
We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly debited to your account.

Contact Us: Canadian Centre for Policy Alternatives•• 1000-141 Laurier Ave W, Ottawa, ON K1P 5J3 •• 613-563-1341 •• [email protected]