Chai Lifeline Canada: Donate

You must have JavaScript enabled in order to use this order form. Please enabled JavaScript and then reload order form in order to continue.

Use the form below to donate to Chai Lifeline.
You can also donate by calling (647) 430-5933
or mailing a check to:
16 Stadacona Drive Unit 1
Toronto, Ontario M6A1Y6

If you would like to receive a tax receipt immediately by email,
then donate through CanadaHelps.org

First Name:
Last Name:
Company Name:
Address:
City:
State/Prov:
Postal Code:
Country:
Phone Number:
Email Address:

Amount:
Card Type:
Card Number:
Exp Month:
Exp Year:
3 Digit Code:
This is the 3 or 4 digit number printed on the front or back of your card.
Comments:

Chai lifeline Canada is a registered Canadian charity Reg. No. 85656 5536 RR0001