To make a donation via PayPal (accepts credit cards), credit card, or Interac, click here.
You will receive a tax receipt for any donation of $20 or more.
If you prefer, you can enter into our pre-authorized debit agreement.
To do so, please print and fill out the form below. Then mail it to Madres de Nicaragua (address below).
You will need to add a void cheque so we have your banking information.
Pre-authorized Debit (PAD) Agreement
Madres de Nicaragua Date: _________
I want to support Madres de Nicaragua through monthly donations.
Please debit my bank account: (attach VOID cheque) $10.00 or ($_____________) monthly
The debit will be processed to your account on the 1st day of each month or the next business day.
Signature: _______________________ Donor Name: __________________________________
Address/Contact Information: _____________________________________________________
______________________________________________________________________________
Email (optional) _______________________________@________________________________
This donation is made by an Individual.
I may revoke my authorization at any time, subject by providing notice of 20 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.
If you have any questions or concerns, please contact me, Robert Loten, via email ([email protected]) or phone (250-888-1341).
Mailing address
Madres de Nicaragua
3313 Susan Marie Pl., Victoria BC V9C 3V3
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.
May we add your name only to the list of donors on the web site Yes ____ No ____