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Pre-Authorized Debit
People's Church - 780-481-2244 ext 26
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* Indicates required question
Email
*
Your email
Church Name
*
Your answer
First & Last Name
*
Your answer
Street
*
Your answer
City
*
Your answer
Phone
*
Your answer
I Would Like To Make The Following Contribution
*
Tithes
Offering
General Missions
Compassion Kids
India Missions
Kids On Track Missions
Music Team
Other
Required
CHECKING/SAVINGS (Please debit my (Check One)
*
Checking aaccount - attach a voided check
Savings Account - attach a voided deposit slip
Required
Routing Number (must start with a 0,1,2 or 3)
*
Your answer
Account Number
*
Your answer
I Authorize the above organization And CAFT Services to process debit entries to the above account. I understant that this authority will remain in effect until I provide reasonable notification to terminate the authorization
*
Your answer
Authorized Signature
*
Your answer
Date of Signing
*
MM
/
DD
/
YYYY
CREDIT/DEBIT CARD - Please charge my
*
Visa
MasterCard
Required
Card #
*
Your answer
Name on Card
*
Your answer
Billing Address
*
Your answer
I Authorize the above organization And CAFT Services to process debit entries to the above account. I understant that this authority will remain in effect until I provide reasonable notification to terminate the authorization
*
Your answer
Date of Signing
*
MM
/
DD
/
YYYY
Pre-Authorized Payment Date (chose one)
*
1st of each month
15th of each month
Both
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