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Registration Form for Support a Child
Preferable Child Age:
Preferable Child Sex :
Male
Female
Title :
Mr.
Miss.
Mrs.
Mr & Mrs.
Name:
*
Complete Address:
*
Postal Code:
*
Home Phone:
*
Office Phone:
Fax Number:
Email Address:
*
Please make cheques payable to: MUSLIM WELFARE CENTRE
I wish to make a contribution by :
Credit Card
Automated Bank Withdrawal
monthly $30
quaterly $90
half yearly $180
yearly $360
Start Date:
(mm)
01
02
03
04
05
06
07
08
09
10
11
12
(yyyy)
2011
2012
2013
2014
2015
End Date:
(mm)
01
02
03
04
05
06
07
08
09
10
11
12
(yyyy)
2011
2012
2013
2014
2015
Credit Card Information
Credit Card Type:
Amex
Mastercard
Visa
Credit Card Owner:
Credit Card Number:
Credit Card Expiry Date:
<Select Month>
January
February
March
April
May
June
July
August
September
October
November
December
*
<Select Year>
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
CVV Number:
This field is required.
Enter correct CVV number
*
Bank Account Information
Financial Institution Name:
Bank Number:
Transit Number:
Account No:
DONATE GENEROUSLY
We accept donations in Cash, Cheque, Debit / Credit Card,
Non-perishable food and other house hold items
Contact Form
Please help the needy irrespective of Religion, Nationality, Caste or Creed.
All donations are Tax Deductible.
Estabilshed in 1993., Registered Charity # 89733-1732-RR-0001
Muslim Welfare Centre
Scarborough (Head Office)
100 McLevin Ave. Suite#4A & 4
Scarborough, Ontario,
Canada, M1B-2V5
Toll Free# 1-866-754-3111
Tel: (416) 754-8116
Fax: (416) 754-4468
Muslim Welfare Home
Whitby
Tel: (905) 665-0424
Toll Free#1-866-666-1115
Fax: (905) 665-1446
Muslim Welfare Centre
Mississauga
3490 Mavis Road, Mississauga
ON, Canada. L5C 1T8
Tel: (905) 281-9730
Fax: (905) 281-9596
Muslim Welfare Centre
Montreal Office
25 Rue Sunshine
D.D.O., QC
Tel: (514) 421-7301
Fax: 1-866-754-3111
Muslim Welfare School
in Pakistan
(Support A Child Program)
167 Arafat Town, Block-L,
N-Nazimbad, Karachi,
Pakistan
Tel: 011-9221-6627430
© 2009 Copyright