President’s Council Form | Civitan International

President's Council

Name(Required)

First Last

Email(Required)

Home Club(Required)

Renewal or New?(Required)

Renewal

New

First Family Member or Additional Family Member(Required)

Are you the first President's Council Member of your household, or an additional family member?

First Family Member

Additional Family Member

Do you wish to make your gift monthly or annually?(Required)

Monthly

Annually

Giving Level: First Family Members - Annual

Giving Level: First Family Members - Monthly

Giving Level: Additional Family Members - Annual

Giving Level: Additional Family Members - Monthly

Total

If Paying by Credit Card

Credit Card Number

CVV

Expiration

Billing Zip

If Paying by eCheck (ACH)

Routing Number

Account Number

Account Type

Recurring Gift Agreement

By checking the box below, you agree that a recurring gift to Civitan International will be automatically processed at the amount and frequency selected above until such time as you choose to end this gift.

I agree