ACOP Southern Ontario District Loan Repayment

Thank you for your payment.

Our donation form is capable of processing both direct bank withdrawals and credit cards and will provide you with the option of giving either a one-time or recurring donation.

If you have any questions or require more information about donating please contact our office at 403-273-5777 or by email at acop@acop.ca.

Contribution Amount *

Total Amount

I want to contribute this amount every month every

I am contributing on behalf of an organization.

On Behalf Of Organization

Organization Name *

Phone (Main) *

Email (Main) *

Street Address *

City *

Postal Code *

Country *

State/Province *

Donor Information

First Name *

Last Name *

Email Address *

Country

Street Address *

City *

Province/State *

Postal Code *

Phone *

Do you wish your donation to be anonymous? *

Yes No

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Date of first contribution

You may select a later start date if you wish.

Donations by cheque

If you wish to donate by cheque, please write the cheque to ACOP of Canada (please add a note "Project 222") and mail your cheque to the following address:

ACOP of Canada
#119, 2340 Pegasus Way NE
Calgary, AB
T2E 8M5