Automatic Withdrawal Form

ACH DEBIT DONATIONS

Camp David International
To easily transfer funds from your bank to Camp David International
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
I would like to give this one time amount of:*
I would like to designate my gift to:*

Camp David InternationalCamp David LiberiaUganda Mission TripStaff SupportCamp David KansasOther
I would like to have this debited on or after this date:
We will do the transfer within 10 days after the date you choose
Another other notes about your donation:
Name(s) on Bank Account (business name if used)*
Routing Number*
must be 9 numbers - no spaces
Account number*
Ussally bewteen 9 and 12 Numbers - no spaces
Bank Name *
Bank Branch*
City, State
Type of Bank Account*

Personal CheckingPersonal SavingsBusiness CheckingBusiness SavingsOther
Bank Phone Number

Area CodePhone Number
Date*

MonthDayYear
Date
Signature*
Enter the message as it's shown*
Should be Empty:

ACH DEBIT DONATIONS