S.J.C.C. Foundation Authorization Form

Saint Joseph’s Catholic Church

Recurring Payment Authorization Form
Please select your preferred payment plan*

$5.00 Monthly$25.00 Monthly$50.00 Monthly$100.00 Monthly$150.00 Monthly
Convenience Fee

I would like to add 3.00% to cover transaction fees.
Name

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Enter Number
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I, First Name Last Name, authorize S.J.C.C. Foundation to charge my credit card for the elected donation selected above.
Signature

Clear

Saint Joseph’s Catholic Church