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Full Name as it appears on Credit Card: |
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Type of Credit Card: |
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Credit Card Last Four
Digits:
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| Address of Record for Credit Card: |
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Purpose: |
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Donation Amount: |
0000.00 |
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Donation Frequency: |
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Donation Starting Date:
(For One-Time Enter Date desired) |
MM/DD/YY |
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Donation Ending Date:
(For One-Time Enter Date desired) |
MM/DD/YY |
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Preferred Time of Month for Donation: |
Credit Card will be debited between 15-20 of each month |
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Telephone Number: |
999-999-9999 |
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E-Mail Address: |
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Envelope Number: |
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Comments: (Explain
Special Donations) |
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By Submission of this Form, I authorize St. Paschal Parish to charge my
Credit Card as listed above: |
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For Web Security - Credit
Card Set-Up Information is transmitted in 3 Steps;
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Basic Information
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Credit card
Number
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Credit Card
Expiration Date
After Submitting Credit Card
Set-Up Information Proceed to Steps 2 & 3 in order to complete
this transaction. Thank You |
