» Automatic Donation Authorization

Donor Name*

First Last

Donor Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone

I authorize FaithBuilders to start transactions and recur monthly on this day of the month:*

Please enter a number from 1 to 28.

I authorize FaithBuilders to credit an automatic transaction for my monthly donation of this amount:*

Payment Method*

Credit Card

Name on Account*

Name on Card*

Card Type*

American Express
Discover
MasterCard
Visa

Card Number*

Expiration Date (MM/YY)*

CSV Code*

Billing Zip Code*

This payment authorization is to remain in effect until I notify FaithBuilders of its cancellation by sending written notice in such time and in such manner to allow both the Organization (FaithBuilders) and the receiving financial institution a reasonable opportunity to act on it. I authorize FaithBuilders to initiate debit entries and, if necessary, initiate credit correction or adjustment entries to my (our) account at the Financial institution indicated above. Please attach a voided check or financial institution verification letter for account validation.

Donor Signature*

Phone

This field is for validation purposes and should be left unchanged.

Donate Monthly with Credit Card