Monthly EFT — Campus Outreach Lynchburg

Give Monthly EFT

Name

First Name

Last Name

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Staff Person

Must choose one.

Checking Account Number

Routing Number

Draft Amount

Enter the number to have drafted each month. For example, if you are making a pledge of $50/month please enter $50.00.

Draft Date

Your account will be drafted on or near this date each month.