| Credit
Card Donation Payment Authorization |
I
authorize ______________________________________________ Church,
to charge my credit card through MyChurchDonations.com for my donation(s) as follows: |
|
Initial |
This
one donation only, in the amount of $ ________________ |
|
______ |
Recurring
___ Weekly,
or ___ Monthly
donations in the |
|
|
amount
of $ ______________, until (Date) ____________. |
| Please
allocate the funds as follows: |
| $_________ |
Tithe |
$_________
Church Expense |
| $_________ |
Sabbath
School Expense |
$_________
Worthy Student Fund |
| $_________ |
Evangelism |
$_________
World Missions |
| $_________ |
Other
_______________________________________________ |
| $_________ |
Other
_______________________________________________ |
| Name
on Card ____________________________________________________ |
|
|
Print
Last |
First |
Middle |
| Credit
Card Number __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __
__ |
| Expiration
Date ______________ CVV Security Code _____________ |
| Type
of Card: ___VISA, ___MasterCard, ___Discover, ___American
Express |
|
Card Holder's
Billing Address for Credit Card Statements.
|
_______________________________________________
Street |
| _______________________________________________ |
| City |
State |
Zip |
|
Phone _______________________
Email ______________________________ |
|
| Signature
_______________________________________________________ |
Date
__________________
Charges will appear on your credit card as MyChurchDonations.com |