Order Here

Charity/Non-profit group you are supporting* :
Name* : Email* :
Address* : Phone* :          
City :
PROV : Postal Code :
To calculate the amount of your cards/certificates order, multiply your weekly purchases by 4. Example: If you spend $125 per week on groceries, you would order $500 in Eat to Give TM cards/certificates. If you spend $50 a week on gas you would order $200 in Gas Up to Give™ cards/certificates. After writing in the amount to be debited, choose the number and denomination of cards/certificates you would like to receive.
Amount to be Debited:
(minimum order $250 in grocery cards/certificates required excluding gas cards)
EAT TO GIVE
Central Fresh Market $25x $50x $100x
Hometown Grocers Co‑Op $25x $50x $100x
(Chelsey Grocery Store, Drayton Foodmarket, L&M Arthur, L&M Durham, Knechtel Food Market – Lucknow, L&M Elora, L&M Harriston, L&M Palmerston)
Loblaws $25x $50x $100x $250x
(Loblaws, Zehrs, No Frills, Value Mart, bloorstreet Market, Fortinos, Your Independent Grocer, Extra Foods, The Real Canadian Superstore & Wholesale Clubs, Maxi & Co, Provigo, Atlantic Superstore, SaveEasy & Super Value)
Longos $20x $50x
Metro/Food Basics $25x $50x $100x
(Metro, A&P, Dominion, Loeb, Ultra Food/Drug, The Barn, Food Basics)
M & M's $25x $50x
Safeway $25x $50x $100x $250x
Save-on-Foods $25x $50x $100x   
Sobey’s/Foodland $25x $50x $100x $250x
(Sobeys, Foodland, Price Chopper, IGA, Knechtels, Town, Omni, Boni Choix, Tradition, Commissio's, Fresh co)
Shoppers Drug Mart $25x $50x
Tim Horton's $15x $25x $50x
GAS UP TO GIVE
Canadian Tire $25x $50x $100x
Chevron $25x
 (gift certificates)
Esso $25x $50x $100x
Husky $25x $50x
Petro Canada $25x $50x $100x
Pioneer $25x $50x $100x
Ultramar $25x $50x
Payment Preference :
Cheque Free
PAP from Bank Account Option
please either enclose a blank, voided cheque, or fill in the following information.
(ignore this #)
Name of Financial Institution:
Branch Address:
Branch number: Institution number: Account number:
(five digits) (three digits) (maximum of twelve digits)
Withdraw Funds

 Full amount on 1st of month
 1/2 of amount on 1st and 15th of month
 Weekly on 1st, 8th, 15th and 22nd of month (minimum $500 order)

I/we the undersigned authorize Community Charity Services to debit my/our account at the Financial Institution indicated. Under the terms and conditions agreed
by me/us with Community Charity Services until such time as written notice to the contrary is given by me/us to CCS. Please Note: You can change the details
of your PAP with 30 days e-mailed/written notice from the date of your first monthly withdrawal.
Registration Forms can be mailed or faxed. Email: CCS at service@charityservices.ca

Mailing Address: CCS, 25 Industrial Drive Suite 7A, Elmira, Ontario N3B 3K3

Phone: 1-519-669-1081 or 1-866-669-2276 Fax: 1-519-669-2573.

I/we have read and understood the terms and conditions and hereby accept them as a condition of my/our participation in PAP Account

Post Dated Cheque (enclosed) Option
Name:
Address:
City:
Postal Code:

I understand how I can get my OPSWA Annual Membership for Free. I am ready to proceed.

I have some questions about ‘Pay the Gift Card Way’ , and I would like to connect with someone at Community Charity Services

Type the Characters you see in the picture below for human verification