Regular Church Giving - Direct Debit Form • Church by the Bridge Kirribilli/St Augustine's Neutral Bay

Regular Church Giving - Direct Debit Form

Three Easy Steps to Regular Church Giving via Direct Debit

This form authorises Church by the Bridge/St Augustine's to periodically debit your bank account or credit/debit card.
The terms of the direct debit service agreement can be obtained by contacting accounts department by phone (8920 9817) or email (accounts@cbtb.org.au).
You can cancel this agreement at any time by again contacting our accounts department by phone (8920 9817) or email (accounts@cbtb.org.au).

Step One: Contact Details

First Name *

Last Name *

Mobile Number *

Email Address *

Which Sunday Gathering do you Attend? *

8am Kirribilli

8am Neutral Bay

10am Kirribilli

10am Neutral Bay

1030am Macquarie Park

4pm Neutral Bay

5pm Kirribilli

6pm Neutral Bay

7pm Kirribilli

Step Two: Select Your Payment Details

Option 1 - Debit my bank account

You can cancel this agreement at any time by phone (8920 9817) or email (accounts@cbtb.org.au)

BSB

Account Number

Account Name

Option 2 - Debit my credit/debit card

You can cancel this agreement at any time by phone (8920 9817) or email (accounts@cbtb.org.au)

Name on Card

Card Number

Expiry Date (MM/YY)

Card Type

Visa

Mastercard

Step 3 - Select the Amount and Frequency, and Accept the Terms

Please nominate the amount to be debited in $ *

How frequently would you like your account debited? *

Weekly

Fortnightly

Monthly

Please nominate the start date *

Please write the name of account holders (both names in the case of a joint account), to confirm you accept the terms of the direct debit service agreement at www.cbtb.org.au/ddr-agreement and authorise Church by the Bridge to debit the nominated account/card according to the above schedule:

Person 1 - First & Last Name *

Person 2 - First & Last Name (joint accounts only)