St
Mark Roman Catholic Church
Stratford, Connecticut
OPTIONAL
ELECTRONIC FUNDS TRANSFER
Complete this simple form and your donation will be automatically
withdrawn from your
checking out on a one time or monthly basis.
OPTIONAL ELECTRONIC FUNDS TRANSFER FORM I authorize the St Mark Roman Catholic Church, to automatically withdraw the following amount from the following checking account: YOUR BANK NAME: __________________________________________________ YOUR BANK ROUTING #: _____________________________________________ YOUR CHECKING ACCOUNT #: ________________________________________ YOUR NAME: ________________________________________________________ YOUR ADDRESS: _____________________________________________________ One time donation: $________________ or MONTHLY: $ _____________ Your Signature: __________________________ Mail form to: |
500
Wigwam Lane, Stratford, CT 06614-2441
Phone (203) 377-0444 - Fax (203) 386-8071 - School (203) 375-4291 - Religious
Education (203) 377-3158