x- Donation Consent

2078 Bombardier Way- CC353
Plymouth, Michigan 48170
Phone Number: 734-927-7307
info@example.com
DD Plan ID:
12345
Donor Name:
First NameLast Name
Donation Amount:
50.00
I authorize you to debit my account with the amounts of direct debits, with this welfare association in accordance with this authority until further notice. I agree that this authority is subject to my bank's terms and conditions that relate to my account. The specific terms and conditions are listed on the donation form. I acknowledge my first credit card donation will be debited immediately and my regular donation will be debited on or around my selected date of each month. I also confirm that I am at least 18 years of age and that I look forward to supporting this welfare association ongoing monthly donations for two years or longer. [Frequency: Monthly]
Clear
This welfare association is a member of the face to face fundraising regulatory body that has calculated that on average its members cost per acquisition is approximately 25% of the average contribution.
For more information please contact us via info@example.com .
Should be Empty: