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Camp Caney: Donation Request
Set up a one time or recurring donation to Camp Caney (automatic withdrawal from your back account)
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* Required
Email
*
Your email
Name (as it appears on your bank account)
*
Your answer
Phone (include area code)
*
Your answer
Address (Street, City, State and Zip Code)
*
Your answer
Bank name
*
Your answer
Routing number (no spaces)
*
Your answer
Account number (no spaces)
*
Your answer
Frequency of donation
*
One Time
Weekly
Monthly
Quarterly
Annually
Amount of donation (ex: $100.00)
*
Your answer
Designate my funds to go toward: (OPTIONAL)
Your answer
Notes: (OPTIONAL)
Your answer
I acknowledge that I am the person whose name has been submitted above. I hereby authorize Caney Conference Center to electronically debit my account. I understand this will remain in effect until I revoke the agreement.
*
I agree
Required
Date Request Submitted (today's date)
*
MM
/
DD
/
YYYY
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