National Episcopal Cursillo

Automatic Monthly Donation/Pledge Form

As a steward of God's gifts and in gratitude for all His Blessings,
I/We make the following Donation/Pledge.

Personal Information

First Name

Last Name

E-mail Address

Street Address

City

State

Zip

Phone Number

Automatic Monthly Donation Information

Repeating Automatic Monthly Donation Amount
*Amount to be charged to my credit card on the 1st of each month.
**This automatic donation can be changed or cancelled at any time.

Name on Card

Billing Address if different from above.

Credit Card Type

Credit Card Number

Exp. Date (mm/yy)

3 or 4-digit Security No.

Donation Comments

Pledge Information

Pledge Amount

Per Week, Month, Year (Check One)

Week

Month

Year

Pledge Comments

Thank you for your pledge! Your continued support will help us grow!
This pledge may be changed or cancelled by giving notice using this online form.

To submit this form, click on "Submit" below.
THANK YOU FOR YOUR SUPPORT. MAY GOD BLESS.

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