Weekly Contribution Rules and Regulations Agreement
Please complete this form to confirm your weekly contribution details and acknowledge the rules and regulations for participation.
Member Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Contribution Plan
Weekly Contribution Amount
*
Contribution Day of Week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Contribution Duration / Commitment Period
*
Please Select
Ongoing
Fixed Term (3 months)
Fixed Term (6 months)
Fixed Term (12 months)
Other
Rules Acknowledgment
Acknowledge and agree to follow the weekly contribution rules and regulations
*
1
I agree
Acknowledgment signature
*
Submit Agreement
Submit Agreement
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