Autodraft Donation Form
I understand that all autodrafts occur on the 15th of the month.
*
Yes
Name
*
First Name
Last Name
If different, name(s) on bank account
Amount of monthly donation $
*
Fund
-- please choose --
General Fund
NFCSN
Local Committee
Disaster Relief
Split between funds
Please describe how you
want to allocate your gifts
Which committee?
Address
*
Street Address
Street Address Line 2
City
State
ZIP Code
E-mail
*
Confirmation Email
Phone number
-
Area Code
Phone Number
Name of Bank
*
Type of account
*
Checking
Savings
*Required fields
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