Pre Authorized Offering Form

Give

Payer's name
First Last
*Charitable Donation Receipt will be made out in this name
Email
Addtional Payer's name (Optional)
First Last
*Charitable Donation Receipt will be made out in this name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
I (we) want to support Harvest Bible Chapel through regular donations. Therefore, please debit my (our) bank account in the fixed amount of:
Frequency (select one)
- 15th of every month
- 30th of every month
- 15th AND 30th of every month
- Every Friday
- Every other Friday
Transaction Start Date
Date Format: MM slash DD slash YYYY
To obtain a cancellation form, or for more information on my (our) right to cancel this agreement, I may contact Harvest Bible Chapel by emailing finance@myharvestchurch.ca or by calling the church office at 705-646-1108.
- I (we) may revoke my (our) authorization at any time by providing written notice to Harvest Bible Chapel.
- I (we) understand that a cancellation request may take up to 30 days to process.
Signature
Today’s date
Date Format: MM slash DD slash YYYY
Photo of a Void Cheque
Accepted file types: jpg, gif, png, pdf.

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