Bank Draft Authorization Form

"*" indicates required fields

Step 1 of 2

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This field is for validation purposes and should be left unchanged.

The purpose of this form is so that Timothy International is able to set up a donation through bank draft.

Thank you!

Today's Date*

Name*

First Last

Email Address:*

Phone Number:*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country