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Credit Card Authorization - Set-Up

You may Set-Up Multiple Credit Card Donations

(Sunday, Capital Campaign, Together in Mission, Rel Ed Fees, etc. - RE: List Below)

 

Full Name as it appears on Credit Card:

Type of Credit Card:

Credit Card Last Four Digits:

 
Address of Record for Credit Card:

Purpose:

Donation Amount:

0000.00

Donation Frequency:

Donation Starting Date:

(For One-Time Enter Date desired)

MM/DD/YY

Donation Ending Date:

(For One-Time Enter Date desired)

MM/DD/YY

Preferred Time of Month for Donation:

(For One-Time Select 1-31)

Telephone Number:

999-999-9999

E-Mail Address:

Envelope Number:

Comments:

By Submission of this Form, I authorize St. Jude Parish to charge my Credit Card as listed above:

For Web Security - Credit Card Set-Up Information is transmitted in 3 Steps;

  1. Basic Information

  2. Credit card Number

  3. Credit Card Expiration Date

After Submitting Credit Card Set-Up Information Proceed to Steps 2 & 3 in order to complete this transaction. Thank You