ELECTRONIC FUNDS TRANSFER (EFT) ENROLLMENT FORM FOR CAPITAL CAMPAIGN
SS. COSMAS & DAMIAN CATHOLIC CHURCH
Please fill out the form below if you want to enroll in this special program to help with mortgage reduction and special projects at SS. Cosmas & Damian Parish.
My reason for filling out this form is:
I wish to enroll in the EFT Capital Campaign Program
I wish to cancel my EFT Capital Campaign Enrollment
I wish to change the amount of my EFT Capital Campaign
I/We wish to commit to pledge the following amount of money
Choose one of the following methods of payment:
One lump sum in the amount of $____________.
The BEGINNING of each month in the amount of $____________.
The MIDDLE of the month in the amount of $____________.
Street Address Line 2
State / Province
Postal / Zip Code
ALL INFORMATION WILL REMAIN CONFIDENTIAL.
I authorize SS, Cosmas & Damian Parish, 10419 Ravenna Rd., Twinsburg, OH 44087 to automatically withdraw my Capital Campaign contribution from my bank.
Bank Account Number
A VOIDED CHECK clearly marked as checking or saving must be sent to the church to provide the necessary routing number. This authority will remain in effect until I notify SS. Cosmas & Damian, in writing, to cancel.
Should be Empty: