Christian Family Radio
WEMI / WEMY
Electronic Funds Transfer (EFT) Form
I wish to authorize Christian Family Radio - WEMI / WEMY (Evangel Ministries, Inc) - to issue an electronic funds transfer from my account for the amount listed below on a monthly basis for deposit into their account at M & I Bank - Fox Valley.
Donor Name(s) ____________________________________
Address
____________________________________
City/State/Zip
____________________________________
Phone Number Day Time
( ) __________ Night Time
( ) __________
Bank Information: Account Type (Check One)
Checking ___ Savings ___
Bank Routing # __________
Bank Account # __________
IF THIS IS FROM A CHECKING ACCOUNT, PLEASE BE SURE TO INCLUDE A VOIDED CHECK SHOWING THE ACCOUNT NUMBER AND ROUTING NUMBER SPECIFIED ABOVE.
Bank Name
_____________________________________________________
Address
_____________________________________________________
City/State/Zip
___________________________________________________
Phone
( ) _________________________
Monthly Transfer Amount $__________ starting (month) ___________ 200__
I understand that the amount above will be withdrawn automatically on or near the 10th of each month until written notice is received by Christian Family Radio to stop.
Signature:
_____________________________ Date:
____________________
Please return this form with your voided check or savings
account information. Mail to:
| Kathy Friesen Director of Accounting Christian Family Radio 1909 W Second St Appleton WI 54914 |
The above transaction to your account will be issued on or near the 10th of each month. A Thank You letter will be issued by us after the EFT transfer has been issued. Please be assured that your account information is kept strictly confidential. Please feel free to contact Kathy Friesen, Director of Accounting with any questions or changes at extension 20 at either 920-749-9364 or 800-236-9364. |
Thank you for your support!