Donation Form

"*" indicates required fields

Donation Information

Donation Amount*

Other*

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Fax

Email*

Payment Information

Credit Card*

Visa

Mastercard

American Express

Name on the Credit Card*

Credit Card Number*

Expiry Date*

Navera Community Connections Inc. respects your privacy. We protect your personal information and adhere to all privacy regulations. If at any time you wish to be removed from our database, contact us by phone at 1-306-244-7773 or via email at reception@navera.org or in writing to #200 – 506 25th Street East, Saskatoon, SK, S7K 4A7 and we will gladly accommodate your request.

If you prefer you may phone Navera and have your donation charged to your credit card. We also accept checks via mail.

I understand,*

that by submitting this form I will not be charged immediately and I agree to allow Navera Community Connections Inc. to charge my credit card for the specified amount. If additional information is required, Navera will reach out using the information provided.