Chalice Home | About Chalice | Contact

Provide Urgent Care

Help provide urgent care to those in need in the developing world. A child may desperately need to undergo life-saving surgery, or a mother may be unable to afford to buy medicine for her sick child. Your donation to our Urgent Care Fund will help those facing pressing medical emergencies and other unexpected circumstances quickly receive the help and treatment they need.

Please note that when donations exceed the request, Chalice will redirect funds to similar activities to help children and families in need.”

Donation Amount

$50
$100
$200
Other

Make this donation in honor of an individual

Donor Information

Name

First Name

Last Name

Organization Name

Contact Information

Address 1

Address 2 (Optional)

Country

Province

State

State/Province

City

Postal Code

Phone Number (Optional)

Email Address

I allow Chalice to contact me by email

I allow Chalice to contact me by mail

Provide Urgent Care

The maximum length allowed in the answer textbox is 1000 characters.

Please specify which urgent need you would like to support.

Provide Urgent Care - General

Comment

Payment Information

Card Holder Name

Card Number

Expiry MM

Expiry YY

CVV (?)

Bank Name

Bank ID

Cheque Number

Transit Number

Account Number

Chalice Home | About Chalice | Contact

Provide Urgent Care

Donation Amount

Tribute Information

Select an E-Card

Select a card

Upload my own image

Card Layout

Sender details

Recipient details

Donor Information

Name

Contact Information

Provide Urgent Care

Payment Information