NonProfit Donation Consent Template

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1044 5th Street
Bremerton, Washington 98337
Phone Number: 360-233-7174
ilovemeforme2018@gmail.com

Nonprofit Organization: Love Me For Me

EIN Number: 86-1231578
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Name
First Name
Last Name
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Donations
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USD
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Description
USD
+ OR enter a custom value
Credit Card
First Name
Last Name
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I authorize you to debit my account with the amounts of direct debits, with this non profit Love Me For Me in accordance with this authority until further notice. I agree that this authority is subject to my bank's terms and conditions that relate to my account. The specific terms and conditions are listed on the donation form. I acknowledge my credit card donation will be debited immediately. I also confirm that I am at least 18 years of age and that I look forward to supporting Love Me For Me* This field is required.
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