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Direct Pay System - Recovery Home Sign-Up
Please use this form to enroll in the Direct Pay System for electronic payments to your recovery home from Pink Cloud Foundation.
If you have any questions,
please contact us at: info@pinkcloudfoundation.org
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to save your progress.
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* Indicates required question
Program Summary
1. Business Name
*
Your answer
2. Primary Email Address
*
Your answer
2a. Secondary Email Address
(optional)
Your answer
3. Bank Routing Number
*
Your answer
4. Bank Account Number
*
Your answer
5. Select Account Type
*
Choose
Business Checking
Business Savings
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