Pre-Authorized Debit

Pre-Authorized Debit Donations

Pre-Authorized Debit (PAD) Form

For those who prefer a physical copy, you can download and print the Pre-Authorized Debit (PAD) here.

Personal Information

I/We authorize Multi-nation Missions Foundation to debit my bank account for:

Donation Type*

Individual, Business, Church, or Charity Donation?

Church Name*

Charity Name*

First Name*

Legal First Name

Last Name*

Legal Last Name

Business Name*

Legal Name Of The Business

E-mail*

Main Email Address

Phone Number

Cell or Home

Address Line 1*

Primary Residence

Address Line 2

Secondary Residence (if applicable)

City*

State / Province / Region*

Postal Code / ZIP*

Country*

Donation

Donation Amount*

Please enter a number greater than or equal to 0.

Please Enter Your Donation Amount

Frequency*

One-Time Donation or Monthly?

Monthly Donation Time*

Choose Which Time Of The Month

Donation Start Time*

Choose Which Month To Start Donations On

Project or Missionary*

Donation Will Be Directed To The Specified Project or Missionary

Void Cheque*

Max. file size: 50 MB.

Please Upload a Void Cheque for the Donation

Comments?

Agreement*

I agree to the terms and conditions located below

This authority is to remain in effect until MMF has received written notification from me of its change or termination. This notification must be received at least 30 days in advance of the next pre-authorized debit at the address above. 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

I/We 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 Pre-Authorized Debit Agreement. To obtain more information on my recourse rights, I may contact my financial institution or visit www.cdnpay.ca