James North Baptist Church Pre-authorized Donation Form

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James North Baptist Church

500 James St N

Hamilton, ON

L8L 1J4
Name

First Name Last Name
Street Address
Postal Code
Home Telephone
Growth Fund Amount
General Fund Amount
I hereby authorize James North Baptist Church to draw the amount indicated above on the 15th of each month beginning in(month) of(year I understand that this authorization may be cancelled at any time upon written notice.
Signature(s) as required on cheques issued against this account

Clear
Second signature if required

Clear
Today's date

Month Day Year
Date
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