Sundance Ranch Feline Sanctuary
Calico Club Application
Fill out the following form completely. Incomplete applications will not be processed
I authorize my bank to pay Sundance Ranch Sanctuary the following each month:
_____ $10 _____$15 _____$25 _____$50 _____ $Other_____
This authorization shall remain in effect until I notify the Sundance Ranch Sanctuary or my bank in writing that I wish to end this agreement and the Sundance Ranch Sanctuary or my bank has had reasonable time to act on it. A record of each transfer will be included in my regular bank statement and serve as my receipt.
CONTACT INFO
Last Name:_________________________________________________
First Name:_________________________________________________
Address:___________________________________________________
NO PO Boxes
City:______________________________________________________
State:_______________ Zip:____________________
Home Phone: (_________)_____________________________________
How did you hear about the Sundance Ranch? ____________________
FINANCIAL INFO
Withdraw Date: ___ 1st of the Month ___ 15th of the Month
Account Number: ____________________________________________
Bank Routing Number: _______________________________________
Bank Name: ________________________________________________
Bank Location: _______________________________________________
Account Type:
Checking______ Savings______ Visa______ MasterCard_____
Signed ___________________________________ Date ____________
Return form to: Sundance Ranch Feline Sanctuary, Calico Club, P.O. Box 5395, Clovis, NM 88102 |
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