Make your child sponsorship payments by Automatic Bank Withdrawal

Activate this service by filling out this form (please print). Mail form and a VOID cheque to:
International Child Care Ministries
4315 Village Centre Court Mississauga
Ontario L4Z 1S2

Automatic Bank Debit Form

Date (Month)/ (Day)/ (Year)  
Name
Address Street Address or Box Number
City State or Province Postal Code
Telephone ( Area code & number - Day) (Area code & number - Evening)
Email
I authorize International Child Care Ministries, a ministry of The Free Methodist Church in Canada, to use the bank information provided by me for the sole purpose of processing my donation for child care sponsorship.

Please debit my account in the amount of $_____________ Beginning Month of _________________ (Payable on the 15th).

Signature _________________________________