Donation Form

DONATION FORM

DATE *

NAME *

ADDRESS *

POSTAL CODE/ PARISH *

HOME NUMBER *

MOBILE NUMBER *

EMAIL ADDRESS *

Please enter your email address.

TAMIS NUMBER: (optional) Required only if you wish to claim the donation as tax-deductible *

DONATION IN BARBADOS DOLLARS *

TYPE OF INSTRUMENT: *

Cheque

Money Order

Electronic Transfer

CHEQUE/MONEY ORDER:

NAME OF FINANCIAL INSTITUTION:

CHEQUE #:

MONEY ORDER #:

ELECTRONIC TRANSFER TRANSACTION CODE/NUMBER:

PLEASE INDICATE THE ORIGIN OF THE FUNDS USED IN THIS TRANSACTION

If you wish to, you may direct your donation to a specific programme: Please tick as many as apply. *

Y Care – Community outreach programme

After School Programme – education and play programmes

Youth and Sports – Sports development programmes

Eye of the Y – Personal development programme

Other

On completion of this form, please post or email to:
The Barbados YMCA, Pinfold Street Bridgetown Barbados, W.I.

Tel: 246-537-0118 E: This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it.

We will gratefully issue a formal receipt acknowledging your kind donation

Privacy Collection Statement

Your privacy is respected by The Barbados YMCA. The personal information that is collected in this form will be used to

collect payment details from you. It may be provided as required or as authorized by law. Your donation may not be

processed if you do not provide the information. We will use the name and address provided on this form may be added to our

database of donors You may opt to be contacted with information about the Barbados YMCA’s programme. If you do not wish to

be contacted, please tick ____

.

If you have any privacy concerns or would like to verify any information provided here, please contact

The Barbados YMCA, Pinfold Street, Bridgetown, Barbados Tel: 1(246) 537-0118/ 1(246) 268-0609

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