Change of Address Form

Please use this table to identify the information you are updating, and complete the corresponding sections.

Information I am updating:	Section(s) of the form to complete:
I want to change my name	Section A and Section B
I want to change my address	Section A, Section B and Section C
I want to change my email and/or phone information	Section A, Section B and Section D
I want to change my monthly gift amount	Section A, Section B and Section E To change your monthly gift amount to below $5: Do not use this form. Call our Donor Care Team at 1-800-661-1083.
I want to update my credit card information for an existing monthly gift	Section A, Section B, Section F and Section G
I want to update my bank account information for an existing monthly gift	Section A, Section B, Section F and Section H
I want to change my payment method for an existing monthly gift	Section A, Section B, Section F and Section G or Section H
I want to become a monthly donor or make a one-time donation	Do not use this form. Visit sickkidsfoundation.com
I want to cancel my monthly gifts	Do not use this form. Call our Donor Care Team at 1-800-661-1083.
I want to make an update that is not listed here	Do not use this form. Call our Donor Care Team at 1-800-661-1083.

If you prefer to update your information by phone, call our Donor Care Team at 1-800-661-1083

* Denotes a required field.

Section A: Current Contact Information

To validate your profile, please provide the existing name and address corresponding to your current donation.

Title: First Name: * Last Name: *

Address Line 1: Address Line 2: City: Province/State: Postal/Zip Code: Country: *

Email address:

Home Phone:

Business Phone:

Cell Phone:

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Section B: Confirm Your Name

Confirm your name above or, enter your new name here:

Title: First Name: * Last Name: *

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Section C: New Address

Change my address to the following:

Address Line 1: Address Line 2: City: Province/State Postal/Zip Code: Country

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Section D: New Email or Phone

Change my email or phone to the following:

Email Address

Home Phone:

Business Phone:

Cell Phone:

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Section E: Monthly Gift Amount

Change my monthly gift amount to the following:

Current monthly gift amount ($)

.00

New monthly gift amount ($)

.00

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Section F: Current Monthly Gift Payment Information

To validate your profile, please provide the existing payment information corresponding to your monthly gift.

Current credit card information:

I currently donate by credit card but do not have this information.

Credit Card Type:

Credit Card Number:

Credit Card Expiry Date: MM/YY

Name on Credit Card:

Current bank account information:

I currently donate by bank account withdrawal but do not have this information.

Bank Name:

Bank #s on bottom of cheque:

Cheque details

Cheque # Branch/Transit # Institution # Account #

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Section G: New Credit Card Information

Change my credit card to the following:

Credit Card Type Credit Card Number: Expiry Month (MM) Expiry Year (YY) Name on Credit Card:

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Section H: New Bank Account Information

Change my bank account information to the following:

New Bank Name: Bank #s on bottom of cheque:

Cheque details

Cheque # Branch/Transit # Bank ID/Institution # Account #

The Hospital for Sick Children Foundation's Pre authorized Debit Agreement

Please print your name to authorize changes made in sections E and H.

Type of pre-authorized debit,

Individual Business

Signature:

Donor signature(s) authorizing monthly pledge and payment details.

Authorization Date

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Additional Comments?

Please provide any additional instructions to help with your request. If you know your Donor ID, you can enter it here:

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Update Your Information

Section A: Current Contact Information

Section B: Confirm Your Name

Section C: New Address

Section D: New Email or Phone

Section E: Monthly Gift Amount

Section F: Current Monthly Gift Payment Information

Section G: New Credit Card Information

Section H: New Bank Account Information

The Hospital for Sick Children Foundation's Pre authorized Debit Agreement