 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Electronic Funds Transfer
KYCC Radio is a 501(c)(3) non-profit ministry. All donations to KYCC are tax deductible.
Copy, Paste, Print this card & indicate the amount you wish to contribute from your checking account.
(This form is for ongoing monthly donations only.)
Please be sure to complete the entire card, print legibly, sign and date the card. Then simply mail or return your completed card WITH A BLANK VOIDED CHECK to:
KYCC Radio, 9019 West Lane, Stockton, CA 95210
Please Transfer my Monthly donation from my checking account. I have included a BLANK VOIDED CHECK.
| Name: |
______________________________________ |
| KYCC ID# (if known): |
______________________________________ |
| Address: |
______________________________________ |
| City: |
______________________________________ |
| State / Zip: |
__________ / _______________________ |
| Day Phone: |
(_________) _________ - _____________ |
| Monthly Gift: |
$____________________________________ |
| Circle one date: | Transfer on 3rd or 18th of the month. |
| Month & Year to begin: |
______________________________________ |
| Today's date: |
_______________________ |
| Signature: |
______________________________________ |