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Sustaining Member FormPrint and Send to:
Sisters Of The Road
YES! I want to become a Sustaining Member of Sisters Of The Road. I would like to make a monthly contribution of:
( )$10.00 ( )$20.00 ( )$30.00 ( )$50.00 Other $_____ I authorize Sisters Of The Road Café, Inc. to receive my monthly contribution of $ _______ , which will be deducted from my checking account on the 5th of each month. My checking account is at: Bank or Credit Union: ______________________________________
Please make out a CHECK, mark it VOID, and attach it to this form. We must have this to process your contribution.
Name ___________________________________________ Signature ________________________________________ Date ______________________________________________ Email ______________________________________________ |
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