Highland Church of Christ 

Fletcher - Peru Mission Work


Direct Draft:  Peru Mission Work 

Thank you for your interest in using direct draft to make your contributions to Highland Church of Christ.  Please fill out the form below and return to the Highland church.  We will contact you prior to any funds being withdrawn from your account to verify the correct date and amounts to draft.

 

Name               ____________________________

 

Address           ____________________________

                        ____________________________

 

Phone              ____________________________

 

E-mail              ____________________________

 

Account to be used (please check one):    Checking _____ or Savings _____

 

If Checking, please attach a voided check to this application.

If Savings, please provide the following information:

 

Routing # ___________________________________

 

Account #___________________________________

 

Frequency of draft:     Once a month on the 5th of the month            __________

                                  Once a week on Monday                               __________

 

Funds to apply draft to and amounts:  Peru Mission - Fletcher

 

Total                             _______________________________

Signature                       ________________________________________   

Date                              _______________________________

 

Should you need to change this information in the future, please contact Amy Pybus at the Highland Church of Christ office at 325.673.5295.  Once completed and signed, this form may be mailed to:  

Highland Church of Christ

Attn:  Amy Pybus, Peru Mission

425 Highland Avenue

Abilene, TX 79605