The Gift That Gives | Alongside You

Gift That Gives

Thanks for your interest in our water bottle, the Gift That Gives! The proceeds from this purchase will go toward the Step Forward Program, providing financial assistance to those in need of additional help in accessing quality mental health care. This includes people at high risk for suicide, single-parent families, individuals on income assistance, individuals struggling with substance misuse, and at-risk youth.

Name of Cardholder*
First Last
Phone of Cardholder*
Email of Cardholder*
Who will be picking up this item?*
The item can be picked up at Alongside You in Ladner at #203-4840 Delta Street, between 9-5 on weekdays.
What is the name of the individual picking up this item?*
First Last
Credit Card Information
If you would prefer to give your credit card information over the phone, please give us a call at 604-283-7827 ext.0 during business hours (9-5) and we'll be happy to process your transaction.
Card Type*
Card Account Number*
Please enter your credit card account number without any spaces.
Card Expiration Date*
Please enter "01" for the expiration day.
Year
Month
DD
3 Digit Security Code*
You can typically find this number on the back of your credit card.
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Consent*
I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. I authorize Alongside You to charge my account for products purchased or services rendered. This does not provide authorization for any additional unrelated charges or credits to the account. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.
Cardholder Signature*
Today's Date*
Please allow 1-2 business days for your purchase to be processed. Once processed, an email receipt will be sent to the email address provided above.
MM slash DD slash YYYY
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Thank You!
Please make sure to drop by #203-4840 Delta Street in Ladner during business hours (9-5) to pick up your water bottle, the Gift That Gives!Thanks from all of us at Alongside You for your support of the Step Forward Program!

Gift That Gives

Credit Card Information

Thank You!