Windsor-Lake St. Clair

Catholic Family of Parishes

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Ste. Anne's Pre-Authorized Debit

PRE-AUTHORIZED DEBIT Registration Form
- This form is not accepting responses at this time.
  
  I/We wish to participate in one of the following pre-authorized debit plan:
  
  Option #1
  
  Weekly Withdrawal I want to set up Weekly Withdrawal
  
  Amount of Weekly Withdrawal Please enter valid data.
  
  Starting Date of Withdrawal Please enter valid data.
  
  Option #2
  
  Monthly Withdrawal I want to set up Monthly Withdrawal
  
  Amount of Monthly Withdrawal Please enter valid data.
  
  Starting Date of Withdrawal Please enter valid data.
  
  Option #3
  
  Bi-Monthly Withdrawal I want to set up Bi-Monthly Withdrawal
  
  Amount of Bi-Monthly Withdrawal Please enter valid data.
  
  Dates of Bi-Monthly Withdrawals Start Date Please enter valid data.
  
  I would like this to be for: REQUIRED Offertory Building Fund Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email Address REQUIRED Please fill out this field. Please enter an email address.
  
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