Sponsor

Sponsor Amount $ (e.g. 180.00)

I would like to cover RCCS's 3% credit card processing fees. My donation total will be $

One Time Donation

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Recurring Donation

Choose a participant you wish to sponsor

Personal Information

First Name: *

Last Name: *

add company name please display my name differently on the scroll.

Please display my name as on the scroll.

Display my name as anonymous

Company Name:

Address: *

City: *

State: *

Zip / Postal: *

Country: *

Phone Number: *

Cell Phone:

Email Address: *

Payment Details

100% of your donation is processed directly through the organization's banking.

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Organization Legal Name
RCCS

RCCS is a recognized Canadian Charity organization- CRA #83436 2055 RR0001

After submitting your donation, you will be redirected to Cardcom to submit your credit card information.

Your card will be charged $

US Currency Canadian Currency

Card Type *

Card Number *

Exp. Month *

Exp. Year *

cvv *

Additional Information (optional)

Donation Type

General Donation In Memory Of In Honor Of For The Recovery Of

Name

To have us notify them/their family a gift has been made in their name, please enter an address or email address, and your message below:

Please mail a receipt to the address above (in addition to the receipt I will receive via email).

Only enter this field if you were told to do so by a staff member.

RCCS is a recognized Canadian Charity organization- CRA #83436 2055 RR0001

A Project of