The Chaeli Campaign's Club CC360: Supporting Sustainable Inclusive Impact
Club CC360 is our Sustainability & Supporter Loyalty Programme. Become a member with a monthly pledge to  support the work done by The Chaeli Campaign.

* International monthly pledges can be made via GivenGain: https://www.givengain.com/cc/clubcc360pledgepartners/ 
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Email *
Name & Surname *
Address *
Mobile Number *
Alternative Contact Number
Email Address *
Club CC360 has 3 tiers of investment. Which will you choose?

When you sign up, you become one of the following:
- Pledge Partner (R0-R999)
- Super Supporter (R1000-R9 999)
- Elite Member (R10 000+)

Monthly Pledge Amount:
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I would like my pledge to support:
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I confirm commencement date of monthly debit as 3rd of each month, commencing on: *
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Bank *
Account Name *
Branch Name *
Branch code *
Account Type *
Account Number *
Would you like a Section 18A Tax Certificate? *
DECLARATION:
I/we hereby instruct and authorise the appointed service provider (on behalf of THE CHAELI CAMPAIGN) to draw against my/our account with the set amount, which is due and payable by me/us in terms of this agreement for the service I/we have selected. This order will remain effective until cancelled by me in writing. I/we may choose to cancel this debit order instruction at any time in writing giving 30 days notice. If cancellation is not implemented before the 15th of the month, the debit order will continue for the next month. I/we understand that there are bank charges associated with this debit order as with all debit orders. 
I/We hereby agree that the above email address will be added to The Chaeli Campaign database to receive updates and information. This information will not be shared with any external parties and will only be used for the intended purpose.
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Date *
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A copy of your responses will be emailed to the address you provided.
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