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Reoccurring donations the hassle-free way: 
 pre-authorized chequing withdrawals

You can use this authorization form to:

  • start reoccurring withdrawals from your chequing account,
  • make changes to your reoccurring withdrawals,
  • authorize a one time withdrawal,
  • or cancel at any time.
1. Fill out this form, print it out and sign it.
2. Mail the form and a blank cheque marked VOID to our office.
3. Allow 2-3 weeks for processing.

Please call or email our office if you need assistance or have any questions.
        
Name:
Address:



Phone:
Email:
  




Amount: 
Start  withdrawals
 Change withdrawals
 Cancel withdrawals
Frequency:
One time gift
 Monthly
 Quarterly (Jan, Apr, Jul, Oct)
Start Date:
Day:  1st       16th
Month:
Year:
Designate:      General Fund        Bridging the Gap DVD Series project
                           Other: __________________________________________
                                             (please read information on designating your donations)
I (we) authorize New Direction for Life Ministries to arrange automatic donations from my (our) account to New Direction starting on the date above. This authorization may be cancelled at any time, subject to providing notice of 5 business days.
I have certain recourse rights if any debit does not comply with this PAD 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

Please provide signature(s) below as required on any cheques issued against this account.

Signature:_________________________________________

Signature:_________________________________________

Date:______________________
 Please remember to enclose a cheque marked 'VOID'


 

© New Direction Ministries of Canada All rights reserved.
P.O. Box 88039 RPO Levi Creek, Mississauga, ON L5N 8M1   Telephone: 416-318-7163

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