This is how I would like to contribute my pledge (select all that apply): I/we wish to start/continue automated monthly withdrawals (PAR) until I/we advise you to stop. * If you are new to PAR please attach a VOID cheque OR credit card information along with the completed PAR form.
I/we’ll make my/our contribution through the United Way at my/our workplace to benefit from employer donation matching.
I/we would like to contribute by credit card. Please contact me/us about making a donation of stock or other financial instrument.
* To donate by credit card please see the “Donate Now” section of the Knox website.
I/we’ll use Knox donation envelopes. Please provide a set.
Please help us keep our records up to date by providing the following. This information will be used by Knox for administrative purposes and not shared with others outside Knox United Church or the Knox United Church Foundation.
Name Street number/unit Email address
Name 2 (optional) Street name
City
Province
Primary Phone
Secondary Phone
Postal code
PAR Authorization Form (For new PAR donors and to make changes to banking details) PAR Congregation Number: 10010260 Name of church PAR contact: Sue Forsyth Phone number: 403.269.8382
Knox United Church Name of local church
Gift Amount
This gift to the above local church is to benefit:
This donation/payment
Local church:
$
Mission and Service Fund1: Other (Knox Foundation)2:
is made by:
$
1.
$
2.
Individual(s)
Business
Funds the United Church Mission & Service initiatives across the nation and the world. Investment Fund for capital expenses and the future of Knox United Church. Preferred Addressee Street number/unit
Donor Name Preferred Addressee
Street name
Donor Name 2 (optional) Preferred Addressee Donor Name 3 (optional)
City
Email address
Province
Postal code
Payment Option 1: Visa or Mastercard Card number
Expiry date
Name on card
Payment Option 2: Pre-authorized Debit Please attach a VOID cheque I/We request/authorize The United Church of Canada to debit my/our account on the 20th of every month, starting the 20th of ____________________________, 20______. I/we also recognize and agree to the following: •
I/we may change the amount of my/our contribution at any time by contacting our church PAR contact
•
I/we have certain recourse rights if any debit does not comply with this agreement. For example, I/we have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAR agreement. To obtain more information on my/our recourse rights, I/we may contact my/our financial institution or visit www.cdnpay.ca.
•
I/we waive my right to receive pre-notification of the amount of pre-authorized remittance (PAR) and agree that I/we do not require advance notice of the amount of PAR before the debit is processed.
Signed
Dated
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation, including but not limited to, the Personal Information Protection and Electronic Documents Act (2000, c.5).
TLKT1262-KUC-Stewardship-WEB-V02-2.7 MB.pdf
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