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Monday, 21 November 2016 20:51

Appeal Form - November 2017

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Affiliate November 2016 Appeal – 4014

Please complete the appropriate section and return the form to:

Maryknoll Fathers and Brothers, PO Box 302, Maryknoll NY 10545-0302

Text Box: 	ONE TIME DONATION
Please make check payable to the Maryknoll Fathers and Brothers and write Maryknoll Affiliates Annual Appeal in the memo line of your check.

Contribution from: ________________________________________  Date: _________________________

Address: ________________________________________________

City: ______________________ State: ___________ Zip/Postal Code: ____________ Country: _______________

Amount:   $25  $50  $100  $200  Other $__________

  Credit Card:  VISA  MasterCard American Express Discover

Name as it appears on card: _________________________________________________________

Card# ___________________________________________________ Expiration Date ___________

Text Box: 	MARYKNOLL MISSION DIRECT AUTHORIZATION FORM FOR  CREDIT/DEBIT CARD USERS:
You can have donations directly charged to a debit card or credit card or debited from your checking account on a monthly, bimonthly, quarterly, semi-annual or annual basis.

I would like to enroll

YES! I would like to make regular automatic transfers to Maryknoll for the Maryknoll Affiliates 4014 Mission Account using my credit or debit card in the amount of $ __________. Should I decide to cancel, I will call Maryknoll. I understand that my donations will be recorded on my statement, which will serve as my receipt.

Debit date is either the 5th or 12th day of the month. Please circle one: 5th or 12th

Your full signature is required here: _______________________________________________________

Please check the giving option you prefer: Monthly Bimonthly Quarterly Semi-Annually  Annually

Name as it appears on card: ________________________________________________________

Address: ________________________________________________

City ____________________________ State _________________

Zip/Postal Code: __________________ Country: ________________

VISA MasterCard American Express Discover     Card # ____________________________________

Expiration Date ________________

Text Box: 	MARYKNOLL MISSION DIRECT AUTHORIZATION FORM FOR  PERSONAL CHECK USERS:
YES! I would like to make an automatic transfer from my bank account to Maryknoll for the Maryknoll Affiliates 4014 Mission Account in the amount of $ __________.

Should I decide to cancel, I will call Maryknoll. I understand that my donations will be recorded on my bank statement, which will serve as my receipt.

Debit date is either the 5th or 12th day of the month. Please circle one: 5th or 12th

Your full signature is required here: ______________________________________________________

Please include voided check along with your donation.

Please check the giving option you prefer: Monthly Bimonthly Quarterly Semi-Annually  Annually

Name: __________________________________________________

Address: ________________________________________________

City ____________________________ State ___________________

Zip/Postal Code _________________________  Country: _______________________________

*  If you are a new enrollee to Maryknoll Mission Direct, please enclose a check for your next donation. After that, your donations will be transferred to Maryknoll electronically.

If you would like to volunteer time and talent, whether you give financially or not, please fill out this portion of the form. You can also email Fred at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 877-897-2386. Please check any ways in which you would be willing to help.

Through prayer                                                                                                        Help edit Not So Far Afield

Write articles for Not So Far Afield                                                               Any other volunteer work as needed

Help translate from and to Spanish for our newsletter, web or other documents

Help update the Maryknoll Affiliate website (articles, news, links, other items of interest)

THANK YOU!

Maryknoll Affiliates

PO Box 311

Maryknoll NY 10545-0311

www.maryknollaffiliates.org


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