St Mark Roman Catholic Church
Stratford, Connecticut

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OPTIONAL ELECTRONIC FUNDS TRANSFER
Complete this simple form and your donation will be automatically withdrawn from your
checking out on a one time or monthly basis.

OPTIONAL ELECTRONIC FUNDS TRANSFER FORM

I authorize the St Mark Roman Catholic Church, to automatically withdraw the following amount from the following checking account:

YOUR BANK NAME: __________________________________________________

YOUR BANK ROUTING #: _____________________________________________

YOUR CHECKING ACCOUNT #: ________________________________________

YOUR NAME: ________________________________________________________

YOUR ADDRESS: _____________________________________________________

One time donation: $________________  or   MONTHLY: $ _____________

Your Signature: __________________________

Mail form to:
St. Mark Church - 500 Wigwam Lane, Stratford, CT 06614


500 Wigwam Lane, Stratford, CT 06614-2441
Phone (203) 377-0444 - Fax (203) 386-8071 - School (203) 375-4291 - Religious Education (203) 377-3158