Want to donate to La Triade HCT?

By making a donation to our organization, you will help marginalized people aged 16 and over with disabilities or skilled immigrants who are disadvantaged in terms of employment. A tax receipt will be provided to you.

DONATION FORM

Donor's full name *

First

Last

Date of donation *

Adress *

Address Line 1

City

State / Province / Region

Postal Code

E-mail *

Single donation amount

Other amount ($)

Monthly donation amount

Other amount ($)

In order to reduce our administrative costs, we suggest that you debit your bank account rather than charge the amount to your credit card. In this way, we would not have to pay fees to financial institutions.

Payment method

I authorize The HCT Triad

I am enclosing a specimen check with the mention "cancelled". I authorize La Triade HCT to debit the amount indicated above from my bank account on the 15th day of each month

I prefer to use my credit card

I authorize The HCT Triad

I authorize La Triade HCT to charge the amount indicated above to my credit card on the 15th day of each month.

Name on credit card:

Credit card number

Credit card expiration date

(Year / Month)

Signature

Message

File sending

Click or drag a file to this area to upload.

Click or drag a file to this area to upload it.

Send this form by fax (514) 368-3641 or by mail to the following address: Triade HCT , 8593 rue centrale, LaSalle (Quebec) H8P1N3 | (514) 368-3640 | www.latriade.ca

A tax receipt is automatically issued for any donation equal to or greater than $10, please request one for any other amount. Registration numbers 830590501R0001

To communicate with you if there is a problem with the credit card in the case of a collective donation, we need the list of all the donors to issue a receipt to each one.

DOWNLOAD THE DONATION FORM (PDF)