Order Form for Existing Customers "(Required *)" indicates required fields Unique IDAre you an existing customer and not changing your address?(Required *) Yes No For new customers or for change of address please use the form here. Order InformationIs this order Personal, Business or a Foundation:(Required *)Please Choose One BelowPersonalBusinessFoundationBusiness Name Foundation Name Name(Required *) Mr.Mrs.MissMs.RabbiDr.Prof. Title First Last Contact Name(Required *) Mr.Mrs.MissMs.RabbiDr.Prof. Title First Last Tax Receipt - who is getting the tax receipt for this order? (tax recipient needs to match donor)(Required *)PersonalBusinessFoundationBusiness Name for Tax Receipt(Required *) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email(Required *) Preferred Phone TypeCellHomeWorkPreferred Number(Required *)Alternate Phone TypeCellHomeWorkAlternate NumberBook InformationDefault Pricing is Credit CardORDER VOUCHERS Order QuantityDenominations Book Value Cash Cost Book Cost Total.50 Cent Value | 50 Vouchers Per Book Price: $ 35.00 CAD Quantity: $ 0.50 Value 50 Vouchers Per Book$25 Credit PriceCash PriceTotal $ 0.00 CAD $1 Value | 50 Vouchers Per Book Price: $ 60.00 CAD Quantity: $1 Value 50 Vouchers Per Book$50 Credit PriceCash PriceSubtotal $ 0.00 CAD $2 Value | 50 Vouchers Per Book Price: $ 115.00 CAD Quantity: $2 Value 50 Vouchers Per Book$100 Credit PriceCash PriceSubtotal $ 0.00 CAD $5 Value | 20 Vouchers Per Book Price: $ 115.00 CAD Quantity: $5 Value 20 Vouchers Per Book$100 Credit priceCash PriceSubtotal $ 0.00 CAD $5 Value | 50 Vouchers Per Book Price: $ 272.00 CAD Quantity: $5 Value 50 Vouchers Per Book$250 Credit PriceCash PriceSubtotal $ 0.00 CAD $10 Value | 20 Vouchers Per Book Price: $ 218.00 CAD Quantity: $10 Value 20 Vouchers Per Book$200 Credit PriceCash PriceSubtotal $ 0.00 CAD $10 Value | 50 Vouchers Per Book Price: $ 544.00 CAD Quantity: $10 Value 50 Vouchers Per Book$500 Credit PriceCash PriceSubtotal $ 0.00 CAD $18 Value | 20 Vouchers Per Book Price: $ 392.00 CAD Quantity: $18 Value 20 Vouchers Per Book$360 Credit PriceCash PriceSubtotal $ 0.00 CAD $18 Value | 50 Vouchers Per Book Price: $ 979.00 CAD Quantity: $18 Value 50 Vouchers Per Book$900 Credit PriceCash PriceSubtotal $ 0.00 CAD $25 Value | 50 Vouchers Per Book Price: $ 1,359.00 CAD Quantity: $25 Value 50 Vouchers Per Book$1,250 Credit PriceCash PriceSubtotal $ 0.00 CAD $36 Value | 50 Vouchers Per Book Price: $ 1,957.00 CAD Quantity: $36 Value 50 Vouchers Per Book$1,800 Credit PriceCash PriceSubtotal $ 0.00 CAD $50 Value | 50 Vouchers Per Book Price: $ 2,718.00 CAD Quantity: $50 Value 50 Vouchers Per Book$2,500 Credit PriceCash PriceSubtotal $ 0.00 CAD $100 Value | 50 Vouchers Per Book Price: $ 5,435.00 CAD Quantity: $100 Value 50 Vouchers Per Book$5,000 Credit PriceCash PriceSubtotal $ 0.00 CAD $180 Value | 30 Vouchers Per Book Price: $ 5,870.00 CAD Quantity: $180 Value 30 Vouchers Per Book$5,400 Credit PriceCash PriceSubtotal $ 0.00 CAD $250 Value | 30 Vouchers Per Book Price: $ 8,153.00 CAD Quantity: $250 Value 30 Vouchers Per Book$7,500 Credit PriceCash PriceSubtotal $ 0.00 CAD Total Payment MethodCredit cardMail ChequeE-transferMy Charity FundDelivery MethodMail OrderPayment processed via Authorize.net• Please make cheque payable to ‘Zichron Binyomin Charity Foundation’ • Please mail cheque to: Zichron Binyomin Charity Foundation, P.O. Box 54085 Lawrence Plaza Post office, Toronto, ON M6A 3B7• Please send E-Transfer to vouchers@zbcf.ca • Please put your order number in the memo• My Charity Fund (MCF) Account needed and further action required • Please sign into your MCF account and make a donation to ZBCF for the full amount of your order and put your order number in the memoAny special instructions or notes for your order? DISCLAIMER: Please Note: You have selected that you ARE an existing customer AND your address on file is current and correct. By submitting this form you are going to be held responsible if you have not told us you have moved and the vouchers get mailed to the wrong home. IF you are unsure if you have updated your account to your new address please Email us before the order gets mailed out to notify us of the new information. vouchers@zbcf.ca. Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name
