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Name: *
E-mail: *
Address:
City/State/Zip:	,
Daytime Phone:
I wish to pledge $ to the 2012 Annual Budget.
I wish to pay using:	By check Electronic Checking MasterCard/Visa Gift of Stock
I AUTHORIZE PLYMOUTH CHURCH TO WITHDRAW FUNDS FROM MY CHECKING ACCOUNT TO PAY MY CHURCH PLEDGE. Please use bank routing information currently on file with Plymouth Church. Name: Amount to be withdrawn on the 20th of each month: $. Bank Routing #: (we'll contact you for this information) Account #: (we'll contact you for this information) This authorization will remain in effect until Plymouth Church has received written notification of its termination. Withdrawals will be updated annually to reflect any change in your pledge. I AUTHORIZE PLYMOUTH CHURCH TO WITHDRAW FUNDS VIA MY CREDIT CARD TO PAY MY CHURCH PLEDGE. Please use the credit card information currently on file with Plymouth Church. Name: Please remember when you select to pay by credit card, Plymouth Church is charged a 3.5% handling fee. We ask you take this into account when making your pledge. We accept only MasterCard or Visa. Amount to be charged on the 20th of each month: $ Credit Card No: (we'll contact you for this information) Expiration Date: (month) (year) Please notify the church when you receive a new card and expiration date. This authorization will remain in effect until Plymouth Church has received written notification of its termination. Withdrawals will be updated annually to reflect any change in your pledge.
Additional Comments: *