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  We will contact you prior to any funds being withdrawn from your account to verify the correct date and amounts to draft.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