Islamic Society of Annapolis
Pledge Form / Donation Form
Name *
Email Address *
Street Address *
City, State, Zip *
Phone: *
Select Payment *
Required
Donation Type *
Donation Amount *
Payment Type *
Card Type:
Card Number:
Card Exp Date:
CVV:
Checking Account Number
Checking Routing Number
DECLARATION: I hereby authorize the Islamic Society of Annapolis to charge my account stated above. This donation will be used for ISA Masjid. I agree to maintain sufficient funds in my account to cover any such debit upon presentation. *
Donor Signature *
Date *
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