I want to GIVE micro-donations

Applicant Name*

Applicant Email*

Applicant Mobile Phone*

Participant Confirmation*

I want to GIVE micro-donations to charities of my choice through the GIVR platform when I pay for shopping

Charities Selection List (Provisional)

Doctors Without Borders

World Widlife Fund

World Food Program

Save the Children

Alternative Charities (not listed)

Donation Percentage (rounded up to the nearest $, £, etc)*

1% of shopping total

2% of shopping total

3% of shopping total

Maximum Total Donation / Month

Communication Preferences*

GIVR may contact me with account and industry related infomation as required

GIVR can only contact me with important or crital account related matters

Message (Optional)