Simple GIVING Program – The Lakeway Church

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Authorization Agreement for Credit/Debit Card Authorization

In gratitude to God and with blessings for my financial support of The Lakeway Church.

I, authorize The Lakeway Church to charge my credit card:

Cardholder First Name: *

Cardholder Last Name: *

Cardholder Company:

Credit Card Billing Address: *

Credit Card Billing City: *

Credit Card Billing State: *

Credit Card Billing Zip: *

Credit Card Country: *

Cardholder Phone: *

Cardholder Email: *

Please let us know how you would like your offering applied:

Student Name: *

Choose an item:
*

Amount of Donation: $*

* Being the cardholder, by checking this box I understand and agree to the terms set forth in this agreement, agree to pay and specifically authorize The Lakeway Church to charge my card.

Authorization Agreement for Credit/Debit Card Authorization

In gratitude to God and with blessings for my financial support of The Lakeway Church.

I, authorize The Lakeway Church to charge my credit card:

Cardholder First Name: *

Cardholder Last Name: *

Cardholder Company:

Credit Card Billing Address: *

Credit Card Billing City: *

Credit Card Billing State: *

Credit Card Billing Zip: *

Credit Card Country: *

Cardholder Phone: *

Cardholder Email: *

Please let us know how you would like your offering applied:

Select Payment Type:

Choose an item:

Specify:

Amount of Donation: $*

* Being the cardholder, by checking this box I understand and agree to the terms set forth in this agreement, agree to pay and specifically authorize The Lakeway Church to charge my card.