Mary's Partners In Peace Registration

Mary's Partners In Peace

Monthly Giving Program
Welcome and thank you for participating in
Mary's Partners In Peace monthly giving program.
Your contribution is essential to Peaceful Remedies' efforts to support those in need.

You have the choice of donating 3 ways:

1) Donate online through the Peaceful Remedies PayPal account using a debit or credit card

2) Direct deposit from your bank account

3) Send it through the USPS mail.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this donation In Memory Of someone?

YES
Please give their name - In Memory
Is this donation In Honor Of someone?

YES
Please give their name - In Honor
Please fill in amount donating each month*
How would you like your name to appear on our website?
Will you be donating online OR by mail?*

Online donation through Peaceful Remedies' PayPal accountDirect deposit from my account (ACH) to Peaceful Remedies' Pathfinder Bank accountUSPS mail
Is there a special message you would like to send to Peaceful Remedies?
Date*

MonthDayYear
Date
Signature*

Clear
Click here to donate through the Peaceful Remedies PayPal account using a debit card or credit card. You do not need a personal PayPal account to use this option.
If you have chosen to make a monthly donation using USPS addressed envelopes to make a monthly donation will be mailed to the address given on this form. You can expect them to arrive in one week or less.
ACH stands for Automated Clearing House, a network that allows electronic money transfers between banks and credit unions in the United States. ACH payments are a type of electronic funds transfer (EFT) and can be used for a variety of purposes.

If you have chosen ACH to make a recurring monthly donation we will email you Peaceful Remedies" bank account number and bank routing number to the email address you have given on this form. Then you can visit your banking institution to set up a monthly transfer.
Should be Empty: