Home
About Us
Mission
What We Do
Staff
Board Members
Testimonies
Counseling
Get Started
Our Model
FAQ's
Training
Donate
Contact Us
Client Access
Home
About Us
Mission
What We Do
Staff
Board Members
Testimonies
Counseling
Get Started
Our Model
FAQ's
Training
Donate
Contact Us
Client Access
Automatic Bank Withdrawal Form
Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Financial Institution
*
Bank Routing #
*
Account #
*
*
Checking
Savings
Monthly Amount
*
$
Allocation of my donation:
*
Penny Carda
Bob Cole
Amy DeLange
Bill Ewing
Joe Ewing
Nic Ewing
Devin Foley
Danielle Haefs
Linda Johnson
Marci Maddux
Sheri Merchen
Chris Parrish
Mark Theissen
General Operating Fund
Client Assistance Fund
I hereby authorize Christian Life Ministries to draft my bank account for my donation. I also hereby authorize Christian Life Ministries to make any correction that needs to be made as a debit or credit to my account. I will contact Christian Life Ministries of any changes in my account number information. Also, I will contact Christian Life Ministries if I wish to discontinue my monthly donations.
*
What month would you like to begin your reoccurring donation on the 15th?
Thank you for supporting God’s work at Christian Life Ministries. Changing lives for eternity!
