Kamloops Community YM-YWCA

^* Required Fields

First Name:^*
Last Name:^*
Company Name:^*
Leave Blank:
Address:^*

City:^*
Province/State:^*
Country:^*
Postal/ZIP Code:^*
Phone:^*	( ) Ext.
Email:^*


Type of donation:	Individual Corporate

Amount:^* (All funds charged in Canadian dollars) $25 $50 $75 $100 Other: $

Credit Card Information

Card Type: ^*
Card Number:^*
CVV:^*	What is this?
Cardholder Name:^*
Expiry Date:^*

Please click Submit button only once

To ensure the security of your personal information your credit card information is processed securely in real time using the latest available encryption technology. IATS Ticketmaster is compliant under Payment Card Industry Data Security Standards (PCI). Look for the locked lock on your browser's status bar to ensure you are submitting your payment information on a secure form.