Giving Tuesday 2024 ACH Authorization

AUTHORIZATION AGREEMENT FOR ACH DEBITS

For Child Sponsorship
I (we) authorize Heart of the Bride Ministries, Inc. (HOB) to initiate debit entries and to initiate, if necessary, credit entries and adjustments for any debit entries in error to my/our Checking or Savings account [select one below]. I authorize the depository named below to debit and/or credit the same to such account on the 15th of each month. Once submitted, I understand that I can only adjust or cancel my donation in writing through mail to the Heart of the Bride home office or by emailing holly@heartofthebride.org. Please indicate the type of account:*

CheckingSavings
Frequency:*

MonthlyOne Time
If monthly; please start my ACH withdrawal on the 15th day of (if blank, withdrawal will happen on the next 15th day of the month):
Month
Bank Name*
City*
State*
Routing/ABA Number*
Account Number*
Amount (Please designate below)*
Your gift will go to the Eagles Christian Academy

to supply the needs of the 9th grade class of 2025. Thank you!
This authority is to remain in effect until HOB has received written/email notification of its termination in such time as to afford HOB and DEPOSITORY a reasonable opportunity to act.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
**If household, please include both husband and wife information.
Name

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date*

MonthDayYear
Date
Type Name
Signature

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AUTHORIZATION AGREEMENT FOR ACH DEBITS
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AUTHORIZATION AGREEMENT FOR ACH DEBITS

Your gift will go to the Eagles Christian Academy

AUTHORIZATION AGREEMENT FOR ACH DEBITS