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Saint Mary's College
The Annual Fund
110 Le Mans Hall
Notre Dame, IN 46556
(1-800) SMC-8871
(1-800-762-8871)
Fax: (574) 284-4749

 

smcafund@saintmarys.edu
Print out this form, complete it and mail to the address at the bottom of this page.

Electronic Fund Transfer Authorization Form
Name
_________________________________________________________________
Home Address
_________________________________________________________________
City/State/Zip Code
_________________________________________________________________
Home Phone
_________________________________________________________________
E-mail address
_________________________________________________________________
Business Address _________________________________________________________________
Is this a new addess?
Yes No
Business Phone
_________________________________________________________________
 

I authorize Saint Mary's College to deduct the amount indicated below each month beginning on the 10th of the current or following month after this form is processed and continuing to further notice. This authorization will remain in effect until I send written notification to both my bank and Saint Mary's College at least five days before the next withdrawl occurs.

 
Signature
_________________________________
Financial Institution Name
_________________________________________________________________
Account Number _________________________________________________________________
Routing & Transit # _________________________________________________________________
Name of branch office _________________________________________________________________
Address of branch office _________________________________________________________________
Starting Date (Month/Year) _________________________________________________________________
Monthly Contribution Amt*
*(min. gift amt. $10)		 $________________________________
Number of Months
for Deduction		 ??_________

Designation:

Financial Aid & Scholarship
Athletics
Other

Remember .... You must enclose a voided check bearing your account number. If using your savings account, please enclose a savings deposit slip.

NOTE: Your EFT Form must be received by the 26th of the month in order to start the 10th of the following month.

Receipts totaling the amount of your Annual Fund gift will be sent to you biannually. Your first receipt will be mailed in January totaling your EFT gifts for the previous calendar year.
Print out this form, complete it and mail to:
Saint Mary's College Annual Fund
Office of Development
110 Le Mans Hall
Notre Dame, IN 46556-9966

Thank you for supporting Saint Mary's College!

If you have questions, please call Heather Frey, Assistant Director; The Annual Fund at (574) 284-4852 or hfrey@saintmarys.edu