PAD Deduction Request
By completing this form, you authorize Phil & Jennie Gaglardi Academy to deduct funds from your Pre-Authorized Debit (PAD) account.
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Child(ren) Enrolled at Gaglardi Academy
*
Transaction Type
*
Please Select
Donation to Gaglardi Academy
Tuition Assistance
Please indicate what the PAD transaction is to be used towards. Please note that all donations to "Gaglardi Academy" are deemed to be unrestricted and able to be used to further the general charitable purposes of the Society. Tuition Support goes directly to helping families with tuition.
Donation Amount:
*
Frequency
*
Please Select
One-Time Donation
Monthly Donation
Please confirm the information that you have provided is correct.
*
Yes, I confirm the above information is correct
Submit
Should be Empty: