Divine Word Automated Giving Enrollment Form Question Title * 1. With gratitude, I wish to offer my gifts of prayer, thanksgiving, and resources to God. I wish to enroll in this safe, free program to make regular contributions to Divine Word Catholic Church. I hereby authorize Divine Word Church of Kirtland, Ohio to initiate debit entries to the following account: Checking Account Saving Account Question Title * 2. I agree the following amount shall be debited: Question Title * 3. Please debit my account as follows: Weekly, every Monday Monthly on the 5th of the month Monthly on the 15th of the month Monthly on the 30th of the month Question Title * 4. Bank Name: Question Title * 5. Bank Address: Question Title * 6. Bank Transit - ABA Number (9 digits): Question Title * 7. Re-enter Bank Transit - ABA Number (9 digits): Question Title * 8. Bank Account Number: Question Title * 9. Re-enter Bank Account Number: Question Title * 10. I agree that this authorization is to remain in effect until Divine Word has received written notification at least ten (10) business days in advance of the desired termination date. Yes Question Title * 11. Name Question Title * 12. Date Date / Time Date Question Title * 13. Additional Comments/Instructions, if needed: Click Here to Submit. Thank you for your gifts!