Monthly Sponsorship Package

Monthly Sponsorship Package

Automatic Payment Set Up Form
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number *
Please enter a valid phone number.
IMPORTANT INFORMATION!
Please print this form once you have filled it out completely and attach a void check from the checking account you want a monthly debit or a deposit slip from the saving account you want a monthly debit.

Once the form is complete, printed, and the check or deposit slip is attached, please mail or drop off to New Horizions, Inc, Attn: Sponsorshop, 237 Six Pine Ranch Rd, Batesville, IN 47006.
Please withdraw my monthly sponsorship gift from my account on the date below. *

1st of month 15th of month
Authorized Signature *

Clear
Should be Empty: