Electronic Funds Transfer Form


OPEN  AIR CAMPAIGNERS - USA / Box D / Nazareth / PA / 18064

We are happy to offer this service and trust it will be a blessing and help to you. Simply print this form on your printer, fill it out and mail it to our Nazareth, PA office with necessary enclosures.  Remember, these transfers may be changed or cancelled at any time by letting us know in writing.  

Your Name:_____________________________________________________

Your Address: ___________________________________________________

City:__________________________   State:_________   Zip:______________

Home Phone:__________________________________ Email: _____________________________________

Bank Name:___________________________________

Please use my contribution(s) for the following OAC missionaries or projects:

    Missionary / Project Name                            Amount
___________________________   $___________________
___________________________   $___________________
___________________________   $___________________
___________________________   $___________________


Make the monthly deduction from my:

_____ CHECKING account (enclose a voided blank check with this form)

_____ SAVINGS account (enclose a savings deposit slip)

I prefer the monthly transfer date of:
_____ 5th of each month      _____ 20th of each month   Starting the month of ____________

I have read, understand and agree with the information on this form and have attached a voided blank check or savings deposit slip to this application. 

Signature:____________________________     Date:____________________

Mail completed form and appropriate attachments to: Open Air Campaigners, PO Box D, Nazareth, PA  18064

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