Gift Membership Payment by eTransfer

Please send a Gift Membership – my eTransfer will follow

Fill out this form for a gift membership payment by eTransfer using the Interac service available through your bank. You will not be required to supply a security question and answer.

If you wish to make your gift membership payment by cheque please go to Gift Membership Payment by Cheque.

Instructions:

1. Enter your personal contact information in the boxes provided.
2. Enter the name associated with the account sending the eTransfer (this is so we can match your form with the eTransfer in case the names differ).
3. Enter the recipient’s name, postal address, and email address.
4. Click the Submit button at the bottom when done.
5. Go to your bank’s website and send Interac payment to: [email protected]
   NOTE: You will not be required to supply a security question and answer. Your Interac payment confirmation will appear with the name of the WLCC Treasurer: Deborah Hall

A new Gift Membership or a Gift Membership Renewal? *

• I would like to send a new WLCC Gift Membership: $20.00 per year
• I would like to RENEW a WLCC Gift Membership: $20.00 per year

Membership Fee: $20 per year *

$20.00 per year

Your Name *

First

Last

Address 1 *

Street Address

Address 2

Apartment/Unit

City *

Municipality or RR#

Province *ABBCMBNBNLNSNTNUONPEQCSKYT

2 Letter Provincial Code

Postal Code [eg: K1A 4B1] *

Canada Postal Code

Your (the Giver's) own personal contact Email address *

Email

Confirm Email

This is the email address for corresponding with the WLCC, for membership emails, etc. NOTE: emails from the WLCC may end up in your Spam or Junk folder unless you add these addresses to your own mail program: [email protected] and [email protected]

The name on the bank account making the Interac payment *

First

Last

IMPORTANT: Make your Interac payment to: [email protected]. Interac confirms payment with the name of the person whose account sent the funds. This may be different from the giver’s personal name, so it is required to enable us to match payment with the application.

Name of Gift Membership Recipient *

First

Last

Gift Recipient's Address 1 *

Street Address

Recipient's Address 2

Apartment/Unit

Recipient's City *

Municipality or RR#

Recipient's Province *ABBCMBNBNLNSNTNUONPEQCSKYT

2 Letter Provincial Code

Recipient's Postal Code [eg: K1A 4B1] *

Canada Postal Code

Recipient's Email address *

Email

Confirm Email

This is the recipient’s email address for membership emails, etc. NOTE: emails from the WLCC may end up in their Spam or Junk folder unless they add our addresses to their mail program: [email protected] and [email protected].

Comment or Message (optional)

Website

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