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:__________________________________
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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