E-Giving Registration Form

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Thank you for using our E-Giving online form. By filling out this form, you are giving your routing and account number to the Parish Business Manager of St. Patrick's and St. Mary's Churches to enroll you in electronic donations to your selected parish. Please note that once this form is submitted, it cannot be terminated unless you submit a written request to the parish. You may contact the Business Manager at any time to adjust your donation. Your donations listed herein are for REGULAR collections only. Second and special collections can be added at your request or during another enrollment campaign

Name *

Email (required) *

Phone Number (in case we need to contact you) *

Envelope Number (if known)

Which Parish are you Donating to? *

What amount do you want deducted? *

How often do you want the above amount to be donated? *

Weekly

Bi-Weekly

Monthly (1st of the Month)

Monthly (15th of the Month)

Quarterly

Make a one time donation of the above amount

Name of Financial Institution (Bank name) *

9 Digit Routing Number *

Account Number *

By Checking this box, I affirm that all information entered above is correct. I hereby authorize St. Patrick’s/St. Mary's Church, hereinafter called COMPANY, to initiate debit entries to my Checking account indicated above and the depository named above, hereinafter called DEPOSITORY, to debit the same to such account. All submissions will be verified by the Parish Business Manager via phone or email. *

I understand and agree that by checking this box, I am digitally signing this submission. This submission remains in full effect until you (the parishioner) requests a termination of e-giving in writing to the COMPANY.

Required

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