pledge-1

Title *    Initials *   
Full Names *
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Surname *
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Cellphone Number
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Email Address
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Postal Address /
Physical Address *
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Which CRC are you from?
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Zone Pastor
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My contribution over and above my tithe towards the third phase of our building project:
Commencement Date
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Number of Months
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Amount (per month)
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Please fill in your Bank details here:
Bank Name
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Branch Name
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Branch Code
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Account Number
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Account Type
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Select your
debit order date
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I agree that a nominal monthly service fee of R4,00 (incl. VAT) will be debited and added to the instalment to cover bank charges. I understand that my financial institution will print the details of each transaction on my bank statement.
Please sign your Pledge form here:
I hereby authorize CRC and any of its nominees to debit my account with the specified amount *
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I hereby authorize CRC and any of its nominees to send me communication via Email and SMS *
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This is an amendment to an existing pledge *
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The undersigned, hereby authorize CRC, or their respective nominees, to debit the Credit Card / Bank Account stated below with the amount indicated on the relevant transaction date:
Please sign with your Full Name below to validate this contract *
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