Automatic Debit by Checking Account

Please fill out the partnership form below. Thank you for partnering with us! Together we can!

*Indicates Required Field
 

*Monthly Donation:

*Please deduct from my checking account on this day each month:

5th15th25th


Personal Information:

*Name:

*Billing  Address



*City:

*State:

*Zip Code:

*Email Address:

*Phone Number:


Checking Account Information

*Routing Number:

*Account Number


*YES! I authorize KLM International to deduct my donation from either my checking account or my credit/debit card account each month. I understand that I control my giving. If at any time I wish to discontinue automatic giving, I will notify KLM International in such a time and manner as to give the organization reasonable opportunity to act. Discontinuing service will not remove me from the KLM International mailing list, and I will still be able to make donations by other means if I so choose.





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